Provider Demographics
NPI:1568581858
Name:BABINEAU, JOHN CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:BABINEAU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 N. CAPITAL OF TX HWY
Mailing Address - Street 2:SUITE E 280
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-306-8900
Mailing Address - Fax:512-306-8652
Practice Address - Street 1:3801 N. CAPITAL OF TX HWY
Practice Address - Street 2:SUITE E 280
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-306-8900
Practice Address - Fax:512-306-8652
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16325122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist