Individual
BALKRISHNA RAMESH GENTYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1064 MASSACHUSETTS AVE, ARLINGTON, MA 02476
(781) 646-4400
Mailing address
1064 MASSACHUSETTS AVE, ARLINGTON, MA 02476-4311
(781) 646-4400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1856347
MA
1223G0001X
General Practice Dentistry
DN1856347
MA
Other
Enumeration date
07/11/2013
Last updated
09/12/2018
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