Provider Demographics
NPI:1003038498
Name:BABIN, JOHN BARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BARRY
Last Name:BABIN
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 1:12511 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-4902
Mailing Address - Country:US
Mailing Address - Phone:224-774-6446
Mailing Address - Fax:224-774-6608
Practice Address - Street 1:12511 PLANK RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-4902
Practice Address - Country:US
Practice Address - Phone:224-774-6446
Practice Address - Fax:224-774-6608
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics