Individual
DR. GEORGE MICHAEL BALACH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5805 GRAND AVE, DULUTH, MN 55807-2459
(218) 624-5965
(218) 624-4628
Mailing address
5805 GRAND AVE, DULUTH, MN 55807-2459
(218) 624-5965
(218) 624-4628
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MN8156
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686817700
—
MN
Enumeration date
07/23/2006
Last updated
07/09/2007
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