Provider Demographics
NPI:1588781132
Name:SHAWN R. HABAKUS, D.M.D., P.C.
Entity type:Organization
Organization Name:SHAWN R. HABAKUS, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HABAKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-385-4845
Mailing Address - Street 1:1008 BEN FRANKLIN HWY W
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1035
Mailing Address - Country:US
Mailing Address - Phone:610-385-4845
Mailing Address - Fax:
Practice Address - Street 1:1008 BEN FRANKLIN HWY W
Practice Address - Street 2:
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1035
Practice Address - Country:US
Practice Address - Phone:610-385-4845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 029070 L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental