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General NPI Number Information
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NPI Number | 1083348502
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Entity Type | Organization
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Legal Business Name | ILB DENTAL PLLC
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 38 MECHANIC ST STE 107
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City | FOXBOROUGH
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State | MA
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Zip | 02035-2072
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Country | US
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Telephone | 508-389-4400
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Fax | 781-480-7677
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Provider Business Mailing Address
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Address Line | 38 MECHANIC ST STE 107
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City | FOXBOROUGH
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State | MA
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Zip | 02035-2072
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Country | US
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Telephone | 508-389-4400
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Fax | 781-480-7677
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Authorized Official
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Title or Position | OWNER
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Name | IRENI BAROUNIS
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Credential | DMD
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Telephone | 508-389-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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