Provider Demographics
NPI:1235235144
Name:BALLINGER, LAUREN KRISTEEN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:KRISTEEN
Last Name:BALLINGER
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 1:200 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6551
Mailing Address - Country:US
Mailing Address - Phone:413-499-4850
Mailing Address - Fax:413-442-0255
Practice Address - Street 1:200 ELM ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6551
Practice Address - Country:US
Practice Address - Phone:413-499-4850
Practice Address - Fax:413-442-0255
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18552641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry