NPI 1003309311

James Keith Ballard, DMD

Practitioner General Practice Dentistry Brookhaven, MS

Practice location

Address: 706 Brookway Blvd, Brookhaven, MS 39601-2640
Phone: (601) 823-3200

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 4005-18 (MS)

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Registry record

NPI: 1003309311
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jun 2018
Record last updated: 11 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.