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General NPI Number Information
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NPI Number | 1841148475
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Entity Type | Organization
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Legal Business Name | KURT O BALLY DMD PA
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 4050 S US HIGHWAY 1 STE 322
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City | JUPITER
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State | FL
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Zip | 33477-1123
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Country | US
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Telephone | 561-691-6055
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 S US HIGHWAY 1 STE 322
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City | JUPITER
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State | FL
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Zip | 33477-1123
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Country | US
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Telephone | 561-691-6055
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | KURT O BALLY
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Credential | DMD
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Telephone | 954-806-6229
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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 |
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License Number State |
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