# JOSEPH D. BALLENGER JR. DDS PA

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

## Provider details

- **NPI number:** 1457546798
- **Authorized official:** DR. JOSEPH DAVID BALLENGER JR. DDS PA (OWNER)
- **Authorized official phone:** (208) 467-1227

## Contact information

- **Practice address:** 339 W IOWA AVE, NAMPA, ID 83686-2856
- **Practice address phone:** (208) 467-1227
- **Practice address fax:** (208) 467-1299
- **Mailing address:** 339 W IOWA AVE, NAMPA, ID 83686-2856
- **Mailing address phone:** (208) 467-1227
- **Mailing address fax:** (208) 467-1299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D-2042-OS | ID | Yes |

## Other

- **Enumeration date:** 09/10/2007
- **Last updated:** 02/26/2008