Individual
NASEM BALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3890 DIXIE HWY, SUITE #1A, SAGINAW, MI 48601-4201
(989) 777-4880
Mailing address
350 N CLARK ST, STE 600, CHICAGO, IL 60654-4712
(312) 274-4526
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021669
MI
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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