Individual
DR. JORDAN J BALVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
129 N VAN RENSSELAER ST, RENSSELAER, IN 47978-2651
(219) 866-8110
(219) 866-8332
Mailing address
PO BOX 27, RENSSELAER, IN 47978-0027
(219) 866-8110
(219) 866-8332
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009450A
IN
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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