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General NPI Number Information
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NPI Number | 1659458396
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Entity Type | Individual
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Provider Name | JOSEPH ANDREW BALASCHAK DMD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 216 DIBERT STREET
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City | JOHNSTOWN
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State | PA
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Zip | 15901
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Country | US
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Telephone | 814-535-7681
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Fax | 814-539-5708
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Provider Business Mailing Address
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Address Line | 501 HOWARD AVENUE BLDG B-108
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City | ALTOONA
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State | PA
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Zip | 16601-4811
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Country | US
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Telephone | 814-942-9701
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Fax | 814-942-7114
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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 | DS020190L
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License Number State | PA
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