Individual
AYMAN A BALSHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
2115 E VIKING AVE, ANAHEIM, CA 92806-4655
(612) 805-9505
Mailing address
2115 E VIKING AVE, ANAHEIM, CA 92806-4655
(612) 805-9505
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
57041
CA
1223P0300X
Periodontics
D12354
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268487000
—
MN
Enumeration date
01/22/2007
Last updated
08/11/2011
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