| Mark R Ballentine Dds,pllc | |
|
9815 Reeck Rd Allen Park MI 48101-1356 | |
| (313) 383-8960 | |
| (313) 383-7313 |
| Full Name | Mark R Ballentine Dds,pllc |
|---|---|
| Speciality | Dentist |
| Location | 9815 Reeck Rd, Allen Park, Michigan |
| Authorized Official Name and Position | Mark Robert Ballentine (SOLE OWNER) |
| Authorized Official Contact | 3133838960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark R Ballentine Dds,pllc 9815 Reeck Rd Allen Park MI 48101-1356 Ph: (313) 383-8960 | Mark R Ballentine Dds,pllc 9815 Reeck Rd Allen Park MI 48101-1356 Ph: (313) 383-8960 |
| NPI Number | 1578708087 |
|---|---|
| Provider Enumeration Date | 12/12/2008 |
| Last Update Date | 12/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578708087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D12983 (Michigan) | Primary |
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