Provider Demographics
NPI:1124306675
Name:LL BALLANCE DDS PLLC
Entity type:Organization
Organization Name:LL BALLANCE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LETITIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALLANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-246-9222
Mailing Address - Street 1:206 WAYNESVILLE PLZ
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-5766
Mailing Address - Country:US
Mailing Address - Phone:828-246-9222
Mailing Address - Fax:828-246-9223
Practice Address - Street 1:205 WAYNESVILLE PLZ
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-5765
Practice Address - Country:US
Practice Address - Phone:828-246-9222
Practice Address - Fax:828-246-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty