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NPI Code Detail

MEDICARE: BALLARD FAMILY DENTISTRY, PA

MEDICARE: BALLARD FAMILY DENTISTRY, PA
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 Dentistry21511TX

General Provider Information

NPI Number : 1477692762
Entity Type Code : Organization
Provider Name (Legal Business Name) : BALLARD FAMILY DENTISTRY, PA
Provider Business Mailing Address
First Line : 701 W BAILEY BOSWELL RD
Second Line :
City : SAGINAW
State : TX
Zip : 76179-1007
Country : US
Telephone Number : 817-367-6453
Fax Number :
Provider Business Practice Location Address
First Line : 701 W BAILEY BOSWELL RD
Second Line :
City : SAGINAW
State : TX
Zip : 76179-1007
Country : US
Telephone Number : 817-367-6453
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : ANGELA JAQUEZ
Credential :
Telephone Number : 817-367-6453
Provider Enumeration Date : 02/05/2007
Last Update Date : 07/01/2008

Similar Medicare Providers

1639246911 — NAZIA H HAQUE DDS
Practice Location Address:
701 W BAILEY BOSWELL RD , SUITE A
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Practice Fax: 817-847-1194
1437289733 — DENTAL SPECIALTY OF SAGINAW
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1083160980 — ALLEN RIDDICK WILLIAMS D.D.S.
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Practice Fax:
1487170726 — DR. KYLE PELLETIER DMD
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1629647524 — MATTHEW CROSS DDS
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Directions to “BALLARD FAMILY DENTISTRY, PA ” Practice Location

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