Provider Demographics
NPI:1326176348
Name:BALAS, GARY P (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:P
Last Name:BALAS
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 1:1430 N ARLINGTON HEIGHTS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4825
Mailing Address - Country:US
Mailing Address - Phone:847-259-4244
Mailing Address - Fax:847-259-4225
Practice Address - Street 1:1430 N ARLINGTON HEIGHTS RD STE 202
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4825
Practice Address - Country:US
Practice Address - Phone:847-259-4244
Practice Address - Fax:847-259-4225
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist