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NPI Code Detail

MEDICARE: DR. EDWARD BALLE DMD

MEDICARE:  DR. EDWARD  BALLE  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6086NV

General Provider Information

NPI Number : 1023315975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD BALLE DMD
Provider Business Mailing Address
First Line : 3041 E FLAMINGO RD
Second Line : SUITE C & D
City : LAS VEGAS
State : NV
Zip : 89121-7446
Country : US
Telephone Number : 702-309-9001
Fax Number :
Provider Business Practice Location Address
First Line : 3041 E FLAMINGO RD
Second Line : SUITE C & D
City : LAS VEGAS
State : NV
Zip : 89121-7446
Country : US
Telephone Number : 702-309-9001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2011
Last Update Date : 08/16/2016

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Directions to “ DR. EDWARD BALLE DMD” Practice Location

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