Individual
ANDREA BALLENGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4405 HIGHWAY 17, MURRELLS INLET, SC 29576-5097
(843) 651-5557
Mailing address
4405 HIGHWAY 17, MURRELLS INLET, SC 29576-5097
(843) 651-5557
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9636
SC
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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