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General NPI Number Information
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NPI Number | 1649482142
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Entity Type | Individual
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Provider Name | ROBERT J. BALFOUR DMD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4 GRANT STREET
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City | PLEASANTVILLE
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State | NY
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Zip | 10570
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Country | US
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Telephone | 914-747-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 2 SPRUCE HILL LANE
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City | GOSHEN
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State | NY
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Zip | 10924
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Country | US
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Telephone | 845-651-3475
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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 | 34226
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License Number State | NY
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