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Organization
INSPIRED DENTAL PLLC
Active
Organization
INSPIRED DENTAL PLLC
Active
Other names
Coolidge Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER ANTHONY BALLEW DDS (OWNER)
(520) 723-1700
Entity
Organization
Contact information
Practice address
1427 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
(520) 723-1700
(520) 723-1702
Mailing address
1427 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
(520) 723-1700
(520) 723-1702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D07579
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134383631
PROVIDER NPI
AZ
01
—
D07579
DENTAL LICENCE
AZ
Enumeration date
08/26/2015
Last updated
08/26/2015
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