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General NPI Number Information
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NPI Number | 1346046521
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Entity Type | Individual
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Provider Name | BRETT JAMES BABBEL DMD, MPH
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Gender | Male
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 921 S. 8TH AVE., STOP 8088
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City | POCATELLO
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State | ID
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Zip | 83209
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Country | US
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Telephone | 208-282-3289
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Fax |
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Provider Business Mailing Address
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Address Line | 5855 E STILL CIR
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City | MESA
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State | AZ
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Zip | 85206-3631
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Country | US
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Telephone | 206-390-2530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5171557
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License Number State | ID
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