Organization
JORDAN J BALVICH, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN J BALVICH D.M.D. (PRESIDENT)
(219) 866-8110
Entity
Organization
Contact information
Practice address
129 N VAN RENSSELAER ST, RENSSELAER, IN 47978-2651
(219) 866-8110
(219) 866-8332
Mailing address
129 N VAN RENSSELAER ST, RENSSELAER, IN 47978-2651
(219) 866-8110
(219) 866-8332
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12009540A
IN
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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