Paul Edward Ballard, DMD Valid NPI

Individual provider · General Practice Dentistry · Vicksburg, MS

NPI

1285845024

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

2063-84 (MS)

Sex

Male

Sole proprietor

No

Enumerated

2007-05-24

Last updated

2007-07-08