Individual
DR. THOMAS KALLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13924 WADAGA RD, BARAGA, MI 49908-9204
(906) 353-7070
Mailing address
N5027 JOE CORN DR, IRON MOUNTAIN, MI 49801-9543
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901012015
MI
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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