| Revere Pediatric Dentistry | |
|
11 Vinal St Revere MA 02151-5326 | |
| (781) 284-3113 | |
| Not Available |
| Full Name | Revere Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 11 Vinal St, Revere, Massachusetts |
| Authorized Official Name and Position | Kamar Maria Baloul (PEDIATRIC DENTIST) |
| Authorized Official Contact | 7812843113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Pediatric Dentistry 11 Vinal St Revere MA 02151-5326 Ph: (781) 284-3113 | Revere Pediatric Dentistry 11 Vinal St Revere MA 02151-5326 Ph: (781) 284-3113 |
| NPI Number | 1912357336 |
|---|---|
| Provider Enumeration Date | 06/16/2016 |
| Last Update Date | 06/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912357336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN20603 (Massachusetts) | Primary |
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