Provider Demographics
NPI:1093939266
Name:BALAMAS, JOHN PETER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PETER
Last Name:BALAMAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 FALL RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-5927
Mailing Address - Country:US
Mailing Address - Phone:508-336-8866
Mailing Address - Fax:508-336-7466
Practice Address - Street 1:1332 FALL RIVER AVE
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-5927
Practice Address - Country:US
Practice Address - Phone:508-336-8866
Practice Address - Fax:508-336-7466
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA186961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice