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
Phone: (304) 448-2101
Fax: (304) 448-3217
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992887392 | NPPES |
| West Virginia | MEDICAID | 4001085000 |
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