Provider Demographics
NPI:1265135289
Name:BABCOCK, JULIE-ANNE (RDH)
Entity type:Individual
Prefix:
First Name:JULIE-ANNE
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1107
Mailing Address - Country:US
Mailing Address - Phone:860-922-9432
Mailing Address - Fax:
Practice Address - Street 1:330 WETHERSFIELD AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1409
Practice Address - Country:US
Practice Address - Phone:860-695-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006563124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist