Individual
DR. BRETT BALLINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
285 W 5600 S, OGDEN, UT 84405-6867
(801) 668-7251
Mailing address
285 W 5600 S, OGDEN, UT 84405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9791650-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2016
Last updated
11/17/2016
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