Balaban, John W

Balaban, John W is an individual health care provider with primary practice located at Route 103, Supply St , Gary WV 24836. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Balaban, John W can be contacted via phone (304) 448-2101.

Contact Information

Primary practice address
Route 103, Supply St Gary WV 24836
Fax: (304) 448-3217
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1793 West Virginia

Profile Details

NPI number 1992887392
LBN Legal business name Balaban, John W
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992887392 NPPES
West Virginia MEDICAID 4001085000

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