Provider Demographics
NPI:1154450211
Name:BALIK, DEBORAH V (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:V
Last Name:BALIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 S. OLD DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-748-4488
Mailing Address - Fax:561-691-0739
Practice Address - Street 1:224 S OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7487
Practice Address - Country:US
Practice Address - Phone:561-748-4488
Practice Address - Fax:561-691-0739
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN117651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice