Provider Demographics
NPI:1669087144
Name:BABB DENTISTRY LLC
Entity type:Organization
Organization Name:BABB DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:812-480-7937
Mailing Address - Street 1:1007 S BOEKE RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-3114
Mailing Address - Country:US
Mailing Address - Phone:812-480-7937
Mailing Address - Fax:
Practice Address - Street 1:2229 W VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5214
Practice Address - Country:US
Practice Address - Phone:812-425-5771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental