Babichenko Dental Lab

NPI #1770623910 in Boise, Idaho

Provider Information

NPI Number: 1770623910
Entity Type: Organization
Organization Name: Babichenko Dental Lab
Primary Specialty: Denturist
Enumeration Date: Feb 7, 2007
Last Updated: Aug 8, 2008

Practice Location

Address: 10480 W GARVERDALE CT
Address 2: SUITE 804B
City: Boise
State: Idaho
ZIP Code: 83704-5411
Phone: (208) 376-6613

Authorized Official

Name: MR. GENNADY S BABICHENKO, LD
Title: OWNER
Phone: (208) 376-6613

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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Provider Name	Specialty	City
MR. Gennady S Babichenko, LD	Denturist	Boise	AI Deep Dive
Charles Rollin Westerberg, LD LICENSED DENTURIS	Denturist	Boise	AI Deep Dive
MRS. Heidi Marie Van Giffen, L.D.	Denturist	Boise	AI Deep Dive
Amanda Jodi Rowe, LD, RDA	Denturist	Boise	AI Deep Dive

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