Provider Demographics
NPI:1801593280
Name:BALLER AND WINELAND LLC
Entity type:Organization
Organization Name:BALLER AND WINELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:BALLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-274-2038
Mailing Address - Street 1:4100 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-2974
Mailing Address - Country:US
Mailing Address - Phone:712-274-2038
Mailing Address - Fax:
Practice Address - Street 1:4100 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2974
Practice Address - Country:US
Practice Address - Phone:712-274-2038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty