# INSPIRED DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coolidge Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154798064
- **Authorized official:** DR. CHRISTOPHER ANTHONY BALLEW DDS (OWNER)
- **Authorized official phone:** (520) 723-1700

## Contact information

- **Practice address:** 1427 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
- **Practice address phone:** (520) 723-1700
- **Practice address fax:** (520) 723-1702
- **Mailing address:** 1427 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
- **Mailing address phone:** (520) 723-1700
- **Mailing address fax:** (520) 723-1702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D07579 | AZ | Yes |

## Other

- **Enumeration date:** 08/26/2015
- **Last updated:** 08/26/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1134383631 | PROVIDER NPI | AZ |
| 01 | — | D07579 | DENTAL LICENCE | AZ |