| NPI | 1588187819 |
|---|---|
| Doing Business As | BALANCED DENTAL |
| Entity Type | Organization |
| Authorized Contact | DAVID CRESTON JACKSON President 772-247-2407 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-10-08 |