Provider Demographics
NPI:1104104496
Name:BABCOCK DENTAL CENTER
Entity type:Organization
Organization Name:BABCOCK DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:Z
Authorized Official - Last Name:QUADRI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:321-984-1991
Mailing Address - Street 1:4711 BABCOCK ST NE
Mailing Address - Street 2:SUITE #28
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2805
Mailing Address - Country:US
Mailing Address - Phone:321-984-1991
Mailing Address - Fax:321-984-0975
Practice Address - Street 1:4711 BABCOCK ST NE
Practice Address - Street 2:SUITE #28
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2805
Practice Address - Country:US
Practice Address - Phone:321-984-1991
Practice Address - Fax:321-984-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental