Individual
DR. BOLANLE MARYAM BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2505 LAPORTE AVE, VALPARAISO, IN 46383-6994
(219) 246-5703
Mailing address
2505 LAPORTE AVE, VALPARAISO, IN 46383-6994
(219) 246-5703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012131A
IN
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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