Provider Demographics
NPI:1720175987
Name:BABCOCK, MORGAN, D.D.S.P.A
Entity Type:Organization
Organization Name:BABCOCK, MORGAN, D.D.S.P.A
Other - Org Name:BABCOCK & MORGAN FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-447-4611
Mailing Address - Street 1:16670 FRANKLIN TRL SE
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-2924
Mailing Address - Country:US
Mailing Address - Phone:952-447-4611
Mailing Address - Fax:
Practice Address - Street 1:16670 FRANKLIN TRL SE
Practice Address - Street 2:
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372-2924
Practice Address - Country:US
Practice Address - Phone:952-447-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty