| NPI | 1518116482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMAR MARIA BALOUL Dentist 617-717-8618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 20603) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |