OrganizationActive
Ballard Dental Group
NPI 1740353408 · General Practice Dentistry · Vicksburg, MS
Provider details
- NPI number
- 1740353408
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Paul Ballard, Owner(601) 634-6277
- License
- 2063-84 (MS)
Specialties & taxonomies
Dental Providers
Practice location
3040 Indiana Avenue
Vicksburg, MS 39180
Phone: (601) 634-6277
Fax: (601) 634-0153
Approximate (ZIP-level) locationGet directions
Mailing address
3040 Indiana Avenue
Vicksburg, MS 39180
Registry dates
- Enumerated
- 2006-11-17
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.