Individual
DR. SOULAFA SUSAN BALOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS, DSCD
Contact information
Practice address
177 TREMONT ST, BOSTON, MA 02111-1020
(617) 617-7677
Mailing address
6 CENTRAL ST, NORWOOD, MA 02062-3504
(781) 769-8000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
27643
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN20656
MA
Other
Enumeration date
05/02/2007
Last updated
07/26/2021
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