Organization
WILLIAM M BALLANCE DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M BALLANCE DDS (DENTIST OWNER SOLE PROPRIETOR)
(804) 732-1278
Entity
Organization
Contact information
Practice address
1964 WAKEFIELD STREET, PETERSBURG, VA 23805
(804) 732-1278
Mailing address
1964 WAKEFIELD STREET, PETERSBURG, VA 23805
(804) 732-1278
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401004200VA
VA
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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