Individual
STEVEN MARK BALLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 HEBRON AVE, SUITE 112, GLASTONBURY, CT 06033-2176
(860) 659-8660
(860) 633-6229
Mailing address
300 HEBRON AVE, SUITE 112, GLASTONBURY, CT 06033-2176
(860) 659-3044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5772
CT
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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