Provider Demographics
NPI:1205037819
Name:BABBITT, WILLIAM R
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:BABBITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-127 LUNAPULE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2119
Mailing Address - Country:US
Mailing Address - Phone:808-329-1567
Mailing Address - Fax:808-326-9262
Practice Address - Street 1:75-127 LUNAPULE RD STE 7
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2119
Practice Address - Country:US
Practice Address - Phone:808-329-1567
Practice Address - Fax:808-326-9262
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIA11241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery