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General NPI Number Information
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NPI Number | 1568476604
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Entity Type | Individual
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Provider Name | ERIK T BALSTER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4207 GLASS RD. NE SUITE 2
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402
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Country | US
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Telephone | 319-294-8181
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Fax | 319-261-8182
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Provider Business Mailing Address
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Address Line | 450 WASHINGTON AVE UNIT 5
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9066
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Country | US
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Telephone | 319-325-1064
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 08359
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License Number State | IA
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