Individual
DR. ANDREW RICHARD BALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6053 NICOLLET AVE, MINNEAPOLIS, MN 55419-2558
(612) 866-3665
(612) 866-9461
Mailing address
6053 NICOLLET AVE, MINNEAPOLIS, MN 55419-2558
(612) 866-3665
(612) 866-9461
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D7932
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74230BA
BLUE CROSS BLUE SHIELD
MN
01
—
8614783
MEDICA MEDICAL
MN
Enumeration date
11/17/2006
Last updated
07/08/2007
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