Ballance & Derose Dds Pa

LBN: Ballance & Derose Dds Pa
Ballance & Derose Dds Pa is an health care organization with primary practice located at 1400 Walter Reed Rd Suite 200, Fayetteville NC 28304-4409. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Ballance & Derose Dds Pa can be contacted via phone (910) 864-9884, or through Derose, Michael Anthony via phone (336) 777-0303.

Contact Information

Primary practice address
1400 Walter Reed Rd Suite 200 Fayetteville NC 28304-4409
Phone: (910) 864-9884
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Derose, Michael Anthony Doctor of Dental Surgery (DDS)
Phone: (336) 777-0303

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1386677961
LBN Legal business name Ballance & Derose Dds Pa
DBA Doing business as
Authorized official Derose, Michael Anthony Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 8th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386677961 NPPES
Other 018C1 BLUE CROSS BLUE SHIELD NC
MEDICAID 5903665 BLUE CROSS BLUE SHIELD NC
Other 1945717 BLUE CROSS BLUE SHIELD NC

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