Provider Demographics
NPI:1861947087
Name:BALLARD, BRITTANY KAYE (DMD)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:KAYE
Last Name:BALLARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:BRITTANY
Other - Middle Name:KAYE
Other - Last Name:CORLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1927 WILMINGTON DR UNIT 202
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6102
Mailing Address - Country:US
Mailing Address - Phone:970-484-4850
Mailing Address - Fax:
Practice Address - Street 1:1927 WILMINGTON DR UNIT 202
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-6102
Practice Address - Country:US
Practice Address - Phone:970-484-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002029371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice