Individual
MATTHEW MARK BALLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
200 ELM ST, PITTSFIELD, MA 01201-6551
(443) 610-7591
Mailing address
200 ELM ST, PITTSFIELD, MA 01201-6551
(443) 610-7591
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12605
MD
Other
Enumeration date
04/04/2007
Last updated
02/09/2012
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