Organization
KOOL KOALA PEDIATRIC & ADOLESCENT DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK BALLARD DDS (OWNER/OPERATOR)
(856) 230-0924
Entity
Organization
Contact information
Practice address
1126 PULASKI HWY, BEAR, DE 19701-1306
(856) 230-0924
Mailing address
103 CURTIS CT, SWEDESBORO, NJ 08085-3223
(856) 230-0924
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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