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Individual

ILYA BABIY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDH, MS, EPP

Contact information

Practice address
26000 SE STARK ST, GRESHAM, OR 97030-3300
(503) 729-2361
Mailing address
26000 SE STARK ST, GRESHAM, OR 97030-3300
(503) 729-2361

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH00007943
WA
124Q00000X
Dental Hygienist
Primary
H5253
OR

Other

Enumeration date
10/29/2010
Last updated
08/12/2015
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