Provider Demographics
NPI:1639584840
Name:BLENDI BABAMETO P.C.
Entity Type:Organization
Organization Name:BLENDI BABAMETO P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLENDI
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAMETO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-606-1813
Mailing Address - Street 1:5279 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9427
Mailing Address - Country:US
Mailing Address - Phone:919-606-1813
Mailing Address - Fax:717-442-8311
Practice Address - Street 1:5279 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9427
Practice Address - Country:US
Practice Address - Phone:919-606-1813
Practice Address - Fax:717-442-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038232261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery