Individual
DR. GLEN BALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3060 MITCHELLVILLE RD, SUITE 213, BOWIE, MD 20716-1389
(301) 249-1841
Mailing address
3313 GRAYVINE LN, BOWIE, MD 20721-2847
(305) 487-2015
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7384
MD
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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