Provider Demographics
NPI:1457581340
Name:BALIN, SILEN
Entity type:Individual
Prefix:
First Name:SILEN
Middle Name:
Last Name:BALIN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SILEN
Other - Middle Name:
Other - Last Name:BALIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:103 OLD MARLTON PIKE
Mailing Address - Street 2:#200
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8772
Mailing Address - Country:US
Mailing Address - Phone:609-953-7123
Mailing Address - Fax:
Practice Address - Street 1:103 OLD MARLTON PIKE
Practice Address - Street 2:#200
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8772
Practice Address - Country:US
Practice Address - Phone:609-953-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-26
Last Update Date:2009-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI02417100122300000X
PADS037982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist