Provider Demographics
NPI:1073231379
Name:MICHAEL BABSTON DMD MD PC
Entity Type:Organization
Organization Name:MICHAEL BABSTON DMD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BABSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:334-669-8634
Mailing Address - Street 1:100 S UNIVERSITY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3043
Mailing Address - Country:US
Mailing Address - Phone:334-669-8634
Mailing Address - Fax:
Practice Address - Street 1:100 S UNIVERSITY BLVD STE A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3043
Practice Address - Country:US
Practice Address - Phone:334-669-8634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty