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General NPI Number Information
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NPI Number | 1275104846
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Entity Type | Individual
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Provider Name | NHI BALOGH DMD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 5200 STONE LAKE DR
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City | WICHITA FALLS
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State | TX
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Zip | 76310-8020
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Country | US
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Telephone | 940-341-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 WEEKS PARK LN APT 111
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City | WICHITA FALLS
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State | TX
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Zip | 76308-3223
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Country | US
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Telephone | 323-712-1771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37313
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License Number State | TX
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