Individual
BLAKE BALLENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 E 128TH AVE, THORNTON, CO 80241-2427
(303) 451-6767
Mailing address
300 E 128TH AVE, THORNTON, CO 80241-2427
(303) 451-6767
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN.00204239
CO
Other
Enumeration date
07/19/2016
Last updated
12/14/2020
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