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401 E Washington Ave Effingham IL 62401-3442 | |
| (217) 342-3411 | |
| (217) 347-6551 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 401 E Washington Ave, Effingham, Illinois |
| Authorized Official Name and Position | Brian A. Balda (DENTIST) |
| Authorized Official Contact | 2173423411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
401 E Washington Ave Effingham IL 62401-3442 Ph: (217) 342-3411 | 401 E Washington Ave Effingham IL 62401-3442 Ph: (217) 342-3411 |
| NPI Number | 1598811499 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 04/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598811499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19-020401 (Illinois) | Primary |
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