| NPI | 1053507400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M BALLANCE Dentist Owner Sole Proprietor 804-732-1278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401004200VA) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |