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General NPI Number Information
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NPI Number | 1699209742
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Entity Type | Individual
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Provider Name | MICHAEL BALL D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2017
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 134 EL CHICO TRL STE 101
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City | WILLOW PARK
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State | TX
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Zip | 76087-8862
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Country | US
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Telephone | 817-995-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1334
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Country | US
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Telephone |
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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 | 34548
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License Number State | TX
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