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Individual

WALTER JOHN BABULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1919 LATHROP ST STE 102, FAIRBANKS, AK 99701-5937
(907) 452-2939
(907) 451-7330
Mailing address
1919 LATHROP ST STE 102, FAIRBANKS, AK 99701-5937
(907) 452-2939
(907) 451-7330

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
330
AK
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9
AK

Other

Enumeration date
07/02/2012
Last updated
07/02/2012
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