| Joseph D. Ballenger Jr. Dds Pa | |
|
339 W Iowa Ave Nampa ID 83686-2856 | |
| (208) 467-1227 | |
| (208) 467-1299 |
| Full Name | Joseph D. Ballenger Jr. Dds Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 339 W Iowa Ave, Nampa, Idaho |
| Authorized Official Name and Position | Joseph David Ballenger (OWNER) |
| Authorized Official Contact | 2084671227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph D. Ballenger Jr. Dds Pa 339 W Iowa Ave Nampa ID 83686-2856 Ph: (208) 467-1227 | Joseph D. Ballenger Jr. Dds Pa 339 W Iowa Ave Nampa ID 83686-2856 Ph: (208) 467-1227 |
| NPI Number | 1457546798 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 02/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457546798 | NPI | - | NPPES |
| 0026640000 | Medicaid | ID | |
| 805475200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D-2042-OS (Idaho) | Primary |
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