| NPI | 1518125640 |
|---|---|
| Doing Business As | BALLARD ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | RICHARD BALLARD President 208-263-4122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D3867OR) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |