Ellen Vandergust Ballard, DDS
NPI #1649452129 in White Rock, New Mexico
Provider Information
- NPI Number
- 1649452129
- Entity Type
- Individual
- Name
- Ellen Vandergust Ballard, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Nov 27, 2007
- Last Updated
- Nov 27, 2007
Practice Location
- Address
- 111 LONGVIEW
- Address 2
- SUITE B-3
- City
- White Rock
- State
- New Mexico
- ZIP Code
- 87544
- Phone
- (505) 672-2020
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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