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Organization

JAMES IAN BALLOU, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES IAN BALLOU DDS (ORTHODONTIST)
(972) 672-9279
Entity
Organization

Contact information

Practice address
2630 S CARRIER PKWY, SUITE A, GRAND PRAIRIE, TX 75052-5069
(972) 660-5522
(972) 660-5525
Mailing address
2630 S CARRIER PKWY, SUITE A, GRAND PRAIRIE, TX 75052-5069
(972) 660-5522
(972) 660-5525

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
25102
TX

Other

Enumeration date
01/14/2010
Last updated
05/11/2011
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