Organization
HAYDEN FAMILY DENTAL CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN D BABCOCK DDS (DENTIST)
(208) 772-3132
Entity
Organization
Contact information
Practice address
52 W COMMERCE DR, HAYDEN, ID 83835-9221
(208) 772-3132
(208) 772-9742
Mailing address
PO BOX 7, HAYDEN, ID 83835-0007
(208) 772-3132
(208) 772-9742
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D2001
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548331986
NPI
ID
01
—
2006003
WA DSHS
WA
Enumeration date
09/28/2010
Last updated
09/28/2010
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