Most Relevant Information
Provider Data
| NPI Number: | 1003309311 |
| Provider Name: | JAMES KEITH BALLARD DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 4005-18 |
Most Important Dates
| Enumeration Date: | 06/11/2018 |
| Last Updated: | 06/11/2018 |
Provider Practice Location
706 BROOKWAY BLVD
BROOKHAVEN
MS
396012640
Practice Location Phone/Fax
| Phone: | 6018233200 |
| Fax: |
Provider Mailing Location
706 BROOKWAY BLVD
BROOKHAVEN
MS
396012640
Provider Mailing Phone/Fax
| Phone: | 6018233200 |
| Fax: |