Organization
LISEL-ANNE BALK, D.M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISEL-ANNE BALK D.M.D. (DENTIST)
(215) 205-5338
Entity
Organization
Contact information
Practice address
5 SOUTH ST, UNIT 3, BRIGHTON, MA 02135-5111
(215) 205-5338
Mailing address
50 STANIFORD ST, SUITE 303, BOSTON, MA 02114-2517
(617) 523-4555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1857120
MA
Other
Enumeration date
12/01/2016
Last updated
01/03/2017
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