Individual
DR. LESZEK ADAM BALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1701 S 1ST AVE, SUITE 102, MAYWOOD, IL 60153-2442
(708) 450-5300
Mailing address
3638 CRAIN ST, SKOKIE, IL 60076-2352
(847) 329-0972
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-017066
IL
1223G0001X
General Practice Dentistry
019-017066
IL
1223G0001X
General Practice Dentistry
2604-015
WI
Other
Enumeration date
03/16/2007
Last updated
04/21/2021
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