Organization
INSPIRED DENTAL PLLC
Active
Other names
Coolidge Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER ANTHONY BALLEW DDS (OWNER)
(520) 723-1700
Entity
Organization
Contact information
Practice address
1427 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
(520) 723-1700
(520) 723-1702
Mailing address
1427 N ARIZONA BLVD, COOLIDGE, AZ 85128-3214
(520) 723-1700
(520) 723-1702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D07579
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134383631
PROVIDER NPI
AZ
01
—
D07579
DENTAL LICENCE
AZ
Enumeration date
08/26/2015
Last updated
08/26/2015
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