# WILLIAM M BALLANCE DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053507400
- **Authorized official:** WILLIAM M BALLANCE DDS (DENTIST OWNER SOLE PROPRIETOR)
- **Authorized official phone:** (804) 732-1278

## Contact information

- **Practice address:** 1964 WAKEFIELD STREET, PETERSBURG, VA 23805
- **Practice address phone:** (804) 732-1278
- **Mailing address:** 1964 WAKEFIELD STREET, PETERSBURG, VA 23805
- **Mailing address phone:** (804) 732-1278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401004200VA | VA | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 09/19/2007