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General NPI Number Information
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NPI Number | 1104104496
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Entity Type | Organization
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Legal Business Name | BABCOCK DENTAL CENTER
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 4711 BABCOCK ST NE SUITE #28
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City | PALM BAY
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State | FL
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Zip | 32905-2805
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Country | US
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Telephone | 321-984-1991
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Fax | 321-984-0975
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Provider Business Mailing Address
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Address Line | 4711 BABCOCK ST NE SUITE #28
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City | PALM BAY
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State | FL
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Zip | 32905-2805
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Country | US
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Telephone | 321-984-1991
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Fax | 321-984-0975
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | SYED Z QUADRI
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Credential | D.M.D.
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Telephone | 321-984-1991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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