Healthcare Provider Details

I. General information

NPI: 1881907988
Provider Name (Legal Business Name): MICHAEL BABSTON D.M.D., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2010
Last Update Date: 08/21/2023
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S UNIVERSITY BLVD BLDG A
MOBILE AL
36608-3043
US

IV. Provider business mailing address

715 DOWNTOWNER BLVD
MOBILE AL
36609-5401
US

V. Phone/Fax

Practice location:
  • Phone: 251-288-8844
  • Fax: 251-283-0488
Mailing address:
  • Phone: 251-471-3381
  • Fax: 251-471-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number5787 C1
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number4192-21
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7276
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5787
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number5787
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: