Organization
BALLET DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOURDES V BALLET DDS (OWNER)
(321) 283-2850
Entity
Organization
Contact information
Practice address
1857 PROVIDENCE BLVD, DELTONA, FL 32725-3811
(321) 283-2850
(386) 951-4809
Mailing address
1857 PROVIDENCE BLVD, DELTONA, FL 32725-3811
(321) 283-2850
(386) 951-4809
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83043
BCBSFL
FL
Enumeration date
04/14/2011
Last updated
04/19/2011
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