Provider Demographics
NPI:1366591976
Name:BALL, JAMES ANDREW JR (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:BALL
Suffix:JR
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 1:630 WEST INTERSTATE 30
Mailing Address - Street 2:610
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5799
Mailing Address - Country:US
Mailing Address - Phone:972-226-7600
Mailing Address - Fax:
Practice Address - Street 1:630 WEST INTERSTATE 30
Practice Address - Street 2:SUITE 610
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5799
Practice Address - Country:US
Practice Address - Phone:972-226-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice