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General NPI Number Information
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NPI Number | 1801409016
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Entity Type | Organization
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Legal Business Name | DANIEL BABADZHANOV DMD PLLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 7025 YELLOWSTONE BLVD STE 1O
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City | FOREST HILLS
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State | NY
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Zip | 11375-3165
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Country | US
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Telephone | 718-797-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 9931 64TH AVE APT B15
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City | REGO PARK
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State | NY
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Zip | 11374-2658
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. DANIEL BABADZHANOV
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Credential | DMD
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Telephone | 631-552-6324
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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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