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DR. RICHARD BLAKESLEE BALLARD D.D.S.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1730275975

Individual Registrant:
DR. RICHARD BLAKESLEE BALLARD D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
716 SUPERIOR AVE  GLADSTONE, MI 49837-1751 US
Tel: 906-428-2321  Fax: 906-428-9499

Contact information for business:
716 SUPERIOR AVE  GLADSTONE, MI 49837-1751 US
Tel: 906-428-2321  Fax: 906-428-9499

Registration Information:
NPI: 1730275975
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
MI2901008970

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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