Individual
DR. MATTHEW JAMES BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2505 N MAYFAIR RD, WAUWATOSA, WI 53226-1404
(414) 258-2117
(414) 258-4117
Mailing address
7736 MARY ELLEN PL, WAUWATOSA, WI 53213-3467
(262) 893-3455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5546
WI
Other
Enumeration date
02/10/2006
Last updated
01/09/2014
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