| Joseph D Ballenger Jr, Dds, Pa | |
|
211 N Whitley Dr Suite 3 Fruitland ID 83619-2704 | |
| (208) 452-4808 | |
| (208) 452-4816 |
| Full Name | Joseph D Ballenger Jr, Dds, Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 211 N Whitley Dr, Fruitland, Idaho |
| Authorized Official Name and Position | Joseph D Ballenger (ORAL & MAXILLONFACIAL SURGEON) |
| Authorized Official Contact | 2084524808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph D Ballenger Jr, Dds, Pa 211 N Whitley Dr Suite 3 Fruitland ID 83619-2704 Ph: (208) 452-4808 | Joseph D Ballenger Jr, Dds, Pa 211 N Whitley Dr Suite 3 Fruitland ID 83619-2704 Ph: (208) 452-4808 |
| NPI Number | 1497858203 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497858203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D-2042-05 (Idaho) | Primary |
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