# RAVI BALU DMD PC

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

## Provider details

- **NPI number:** 1942474879
- **Authorized official:** MS. CAROL FOSTER (OFFICE MANAGER)
- **Authorized official phone:** (724) 628-9340

## Contact information

- **Practice address:** 210 LAUREL DR, CONNELLSVILLE, PA 15425-3869
- **Practice address phone:** (724) 628-9340
- **Practice address fax:** (724) 628-4090
- **Mailing address:** 210 LAUREL DR, CONNELLSVILLE, PA 15425-3869
- **Mailing address phone:** (724) 628-9340
- **Mailing address fax:** (724) 628-4090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS015819L | PA | — |
| 122300000X | Dentist | DS027029L | PA | Yes |
| 122300000X | Dentist | DS031148L | PA | — |
| 122300000X | Dentist | DS037382 | PA | — |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 06/27/2008