Provider Demographics
NPI:1144300658
Name:BALLARD, JAMES FLETCHER (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FLETCHER
Last Name:BALLARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1771 INDEPENDENCE COURT
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35217
Mailing Address - Country:US
Mailing Address - Phone:205-414-1499
Mailing Address - Fax:205-414-8244
Practice Address - Street 1:1771 INDEPENDENCE CT
Practice Address - Street 2:SUITE 4
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1258
Practice Address - Country:US
Practice Address - Phone:205-414-1499
Practice Address - Fax:205-414-8244
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics