MEDICARE: DR. SCOTT ALLEN BABIN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE00010194	WA

General Provider Information

NPI Number	:	1750302030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALLEN BABIN D.D.S.

Provider Business Mailing Address
First Line	:	7631 212TH ST SW SUITE 109C
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-7565
Country	:	US
Telephone Number	:	425-629-8228
Fax Number	:	425-673-2856

Provider Business Practice Location Address
First Line	:	7631 212TH ST SW SUITE 109C
Second Line	:
City	:	EDMONDS
State	:	WA
Zip	:	98026-7565
Country	:	US
Telephone Number	:	425-629-8228
Fax Number	:	425-673-2856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	06/20/2023

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