Organization
JOSEPH D BALLENGER JR, DDS, PA
Active
Other names
Comstock & Ballenger LLS
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH D BALLENGER JR. DDS, PA (ORAL & MAXILLONFACIAL SURGEON)
(208) 452-4808
Entity
Organization
Contact information
Practice address
211 N WHITLEY DR, SUITE 3, FRUITLAND, ID 83619-2704
(208) 452-4808
(208) 452-4816
Mailing address
211 N WHITLEY DR, SUITE 3, FRUITLAND, ID 83619-2704
(208) 452-4808
(208) 452-4816
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D-2042-05
ID
Other
Enumeration date
09/07/2006
Last updated
08/22/2020
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