Provider Demographics
NPI:1235206210
Name:BALSHAW, ANDREW GEOFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GEOFFREY
Last Name:BALSHAW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 STATE ST STE 14
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5530
Mailing Address - Country:US
Mailing Address - Phone:805-687-9902
Mailing Address - Fax:805-687-3397
Practice Address - Street 1:2780 STATE ST STE 14
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5530
Practice Address - Country:US
Practice Address - Phone:805-687-9902
Practice Address - Fax:805-687-3397
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
521932886OtherFEDERAL TAX ID