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Contact Information

ANDREW J BALAZE, DMD
306 W WASHINGTON AVE STE 205
JACKSON, MI49201-2141
 Phone: 517-787-5055
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for ANDREW J BALAZE · (Male)

NPI Number 1851730592
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 06/16/2013
Last updated 08/07/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # 2901020967
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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