Provider Demographics
NPI:1144552043
Name:BAL DENTAL INC
Entity type:Organization
Organization Name:BAL DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSIMRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-723-4777
Mailing Address - Street 1:5959 GREENBACK LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-4700
Mailing Address - Country:US
Mailing Address - Phone:916-723-4777
Mailing Address - Fax:916-723-4725
Practice Address - Street 1:5959 GREENBACK LN
Practice Address - Street 2:SUITE 110
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4700
Practice Address - Country:US
Practice Address - Phone:916-723-4777
Practice Address - Fax:916-723-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty