Provider Demographics
NPI:1386891323
Name:BABCOCK, PATRICIA JACKSON (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JACKSON
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325C WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5348
Mailing Address - Country:US
Mailing Address - Phone:410-796-0020
Mailing Address - Fax:
Practice Address - Street 1:6325C WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5348
Practice Address - Country:US
Practice Address - Phone:410-796-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice