Individual
JOHN GEORGE BALLOUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6873
(313) 494-6834
Mailing address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6873
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2901602663
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/20/2025
Last updated
07/15/2025
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