NPI 1770623910

Babichenko Dental Lab

Organisation Denturist Boise, ID

Practice location

Address: 10480 W Garverdale CT Suite 804b, Boise, ID 83704-5411
Phone: (208) 376-6613
Fax: (208) 376-6613

Authorised official

Name: Gennady S Babichenko
Title: Owner
Phone: (208) 376-6613

Registered specialties

Denturist Primary

Dental Providers Taxonomy 122400000X Licence LD44 (ID)

Other Denturist providers in Idaho →

Registry record

NPI: 1770623910
Entity type: Organization
NPI issued: 7 Feb 2007
Record last updated: 8 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.