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General NPI Number Information
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NPI Number | 1184845562
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Entity Type | Organization
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Legal Business Name | LILIBETH L. BABAO, DDS, A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 73625 HIGHWAY 111 STE E
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City | PALM DESERT
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State | CA
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Zip | 92260-4010
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Country | US
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Telephone | 760-674-8114
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Fax | 760-674-8115
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Provider Business Mailing Address
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Address Line | 73625 HIGHWAY 111 STE E
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City | PALM DESERT
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State | CA
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Zip | 92260-4010
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Country | US
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Telephone | 760-674-8114
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Fax | 760-674-8115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LILIBETH LACANDULA BABAO
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Credential | DDS
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Telephone | 760-674-8114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 43415
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License Number State | CA
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