Organization Name: | BALATGEK FAMILY DENTAL, LLC |
NPI Number: | 1578629143 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH BALATGEK (MEMBER) |
Mailing Address: | 803 Mountain Home Rd Sinking Spring |
State: | PA US |
Postal Code: | 196089319 |
Phone Number: | 6106782777 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DS030170L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |