Individual
ERIC BALLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5355 W STATE ST, BOISE, ID 83703-3333
(208) 853-4687
(208) 853-4690
Mailing address
5355 W STATE ST, BOISE, ID 83703-3333
(208) 853-4687
(208) 853-4690
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4142
ID
Other
Enumeration date
06/12/2008
Last updated
02/12/2024
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