Organization · NPI-2
Babichenko Dental Lab
Denturist · Boise, ID
NPI number1770623910
StatusActive
Last updated in NPPESAug 8, 2008
Details
- NPI
- 1770623910
- Entity type
- Organization (NPI-2)
- Legal business name
- Babichenko Dental Lab
- Organization subpart
- No
- Enumeration date
- Feb 7, 2007
- Last updated
- Aug 8, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122400000X | Denturist | LD44 | ID | Yes |
Other names
- European Denture Center (Doing Business As)
Practice location
10480 W Garverdale CtSuite 804b
Boise, ID 83704-5411
Phone 208-376-6613 · Fax 208-376-6613
Mailing address
10480 W Garverdale CtSuite 804b
Boise, ID 83704-5411
Phone 208-376-6613 · Fax 208-376-6613
Authorized official
Gennady S Babichenko
Owner
2083766613
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