| NPI | 1700626835 |
|---|---|
| Doing Business As | BRUSH AND FLOSS SPECIALTY - BALLANTYNE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICCOBENE Owner 855-417-4226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-05-28 |