| NPI | 1144593674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW M BALLINGER Dentis 443-610-7591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855264) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |