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NPI Provider: 1619972205
Contact Name: Ballou L Fred
Position: President/Owner
Phone: (859) 623-3818
Fred L Ballou, Dmd, Psc Information:
Fred L Ballou, Dmd, Psc organization have npi 1619972205, taxonomy code is 1223G0001X with license number is 3905 in . This Business address located in 311 Radio Park Dr, Richmond, KY 40475 Kentucky. Get directions of Fred L Ballou, Dmd, Psc.
Practice Location
Address: 311 Radio Park Dr, Richmond, KY 40475
Phone: (859) 623-3818
Business Location
Address: 311 Radio Park Dr, Richmond, KY 40475
Phone: (859) 623-3818
Fax: (859) 624-1061
Taxonomy
Taxonomy Code: 1223G0001X
License Number: 3905
License Number of State: KY
Primary Taxonomy Switch: Y
Enumeration Date: 6/20/2005
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