Balentine, E. Lee

Balentine, E. Lee is an individual health care provider with primary practice located at 503 Deschutes Ave , Maupin OR 97037-0147. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Balentine, E. Lee can be contacted via phone (541) 395-2636.

Contact Information

Primary practice address
503 Deschutes Ave Maupin OR 97037-0147
Phone: (541) 395-2636
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D5022 Oregon

Profile Details

NPI number 1154316362
LBN Legal business name Balentine, E. Lee
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
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 1154316362 NPPES
Oregon Other 220483 OREGON HEALTH PLAN

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