Provider Demographics
NPI:1306030929
Name:MJ BABIK DDS AND ASSOCIATES LTD
Entity Type:Organization
Organization Name:MJ BABIK DDS AND ASSOCIATES LTD
Other - Org Name:CROSSRIDGE FAMILY AND COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BABIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-755-8050
Mailing Address - Street 1:10170 STAPLES MILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3450
Mailing Address - Country:US
Mailing Address - Phone:804-755-8050
Mailing Address - Fax:804-755-8053
Practice Address - Street 1:10170 STAPLES MILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3450
Practice Address - Country:US
Practice Address - Phone:804-755-8050
Practice Address - Fax:804-755-8053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410851305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization