Individual provider · NPI-1

Dr. George Robert Ballew, DDS

Dentist, General Practice · Muskogee, OK

NPI number1922148345
StatusActive
Last updated in NPPESAug 19, 2026

Details

NPI
1922148345
Entity type
Individual (NPI-1)
Name
Dr. George Robert Ballew
Credential
DDS
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 7, 2007
Certification date
Aug 19, 2026
Last updated
Aug 19, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice4805OKYes

Practice location

3201 W Broadway St
Muskogee, OK 74401-2132

Phone 918-686-6684 · Fax 918-686-6919

Mailing address

3201 W Broadway St
Muskogee, OK 74401-2132

Phone 918-686-6684 · Fax 918-686-6919

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