Individual
DR. SUMATI BHALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
20 MAVERICK SQ, EAST BOSTON, MA 02128-2335
(617) 569-5800
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1931
(617) 569-5800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1859152
MA
Other
Enumeration date
08/08/2021
Last updated
10/25/2021
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