Revere Pediatric Dentistry
NPI #1912357336 in Revere, Massachusetts
Provider Information
- NPI Number
- 1912357336
- Entity Type
- Organization
- Organization Name
- Revere Pediatric Dentistry
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Jun 16, 2016
- Last Updated
- Jun 16, 2016
Practice Location
- Address
- 11 VINAL ST
- City
- Revere
- State
- Massachusetts
- ZIP Code
- 02151-5326
- Phone
- (781) 284-3113
Authorized Official
- Name
- DR. KAMAR MARIA BALOUL, DMD
- Title
- PEDIATRIC DENTIST
- Phone
- (781) 284-3113
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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