Individual
JOSEPH DAVID BALLENGER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
339 W IOWA AVE, NAMPA, ID 83686-2856
(208) 467-1227
(208) 467-1299
Mailing address
339 W IOWA AVE, NAMPA, ID 83686-2856
(208) 467-1227
(208) 467-1299
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D20420S
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002664000
—
ID
05
—
002664100
—
ID
Enumeration date
08/04/2006
Last updated
02/25/2008
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