Organization
SHELDON A. BALLOU, DMD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELDON ARCH BALLOU DMD (PRESIDENT)
(270) 773-3943
Entity
Organization
Contact information
Practice address
203 S DIXIE HWY, CAVE CITY, KY 42127-8866
(270) 773-3943
(270) 773-3944
Mailing address
203 S DIXIE HWY, CAVE CITY, KY 42127-8866
(270) 773-3943
(270) 773-3944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6425
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60064250
—
KY
Enumeration date
01/18/2007
Last updated
05/12/2008
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