Individual provider · NPI-1

Linda Sue Ballard, RDH

Dental Hygienist · Aurora, CO

NPI number1083986962
StatusActive
Last updated in NPPESFeb 7, 2012

Details

NPI
1083986962
Entity type
Individual (NPI-1)
Name
Mrs. Linda Sue Ballard
Credential
RDH
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 7, 2012
Last updated
Feb 7, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
124Q00000X Dental Hygienist903543COYes

Practice location

13065 E 17th Ave
Aurora, CO 80045-2532

Phone 303-724-5055

Mailing address

15639 E Purdue Dr
Aurora, CO 80013-2552

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