Individual
DR. ANDREA ELISABETH BALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5760 N TELEGRAPH RD, DEARBORN HEIGHTS, MI 98127
(313) 277-2107
(313) 277-2108
Mailing address
220 S MELBORN ST, DEARBORN, MI 48124
(313) 565-6080
(313) 565-6080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901014594
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1958214590
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/01/2007
Last updated
07/08/2007
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