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Individual

DR. LAUREN JEAN BALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1604 C NORTH MAIN STREET, MOUNTAIN GROVE, MO 65711-0000
(417) 926-1209
(417) 683-1602
Mailing address
PO BOX 1359, AVA, MO 65608-1359
(417) 683-4831
(417) 683-1602

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2003001288
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851501423
MO
Enumeration date
05/23/2007
Last updated
02/03/2016
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