Organization
1500 GRANT BLVD DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARUN BALAKUMAR DDS (CEO)
(315) 472-3414
Entity
Organization
Contact information
Practice address
1500 GRANT BLVD, SYRACUSE, NY 13208-3014
(315) 472-3414
(315) 472-4320
Mailing address
1500 GRANT BLVD, SYRACUSE, NY 13208-3014
(315) 472-3414
(315) 472-4320
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
051141
NY
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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