Organization
CLARA E. BALANCIO, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARA ESPINOZA BALANCIO DDS (DOCTOR)
(707) 643-2273
Entity
Organization
Contact information
Practice address
2809 REDWOOD PKWY, VALLEJO, CA 94591-3634
(707) 643-2273
Mailing address
2809 REDWOOD PKWY, VALLEJO, CA 94591-3634
(707) 643-2273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
49040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083735831
NPI
CA
Enumeration date
07/27/2007
Last updated
07/27/2007
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