Provider Demographics
NPI:1316955503
Name:BALSAMO, FRANCIS XAVIER (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:XAVIER
Last Name:BALSAMO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-2042
Mailing Address - Country:US
Mailing Address - Phone:201-641-9119
Mailing Address - Fax:201-641-2664
Practice Address - Street 1:134 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643-2042
Practice Address - Country:US
Practice Address - Phone:201-641-9119
Practice Address - Fax:201-641-2664
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011693001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice