NPI | 1750580288 |
---|---|
Professional Name | SAM DEAN BALDERSTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 42119) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 42119) |
Enumeration Date | 2007-07-14 |
Last Update Date | 2022-02-09 |