Individual
LETITIA LYNN BALLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
205 WAYNESVILLE PLZ, WAYNESVILLE, NC 28786-5765
(828) 452-5656
(828) 452-5680
Mailing address
205 WAYNESVILLE PLZ, WAYNESVILLE, NC 28786-5765
(828) 452-5656
(828) 452-5680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6485
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89-9005C
—
NC
01
—
9005C
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
08/25/2006
Last updated
09/20/2012
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