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BABICHENKO DENTAL LAB

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Company Details

Name: BABICHENKO DENTAL LAB
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 10 Oct 2000 (25 years ago)
Entity Number: 131093
Place of Formation: IDAHO
File Number: 0000131093
ZIP code: 83605
County: Canyon County
Mailing Address: 6118 CLEVELAND BLVD CALDWELL, ID 83605

National Provider Identifier

NPI Number:
1770623910

Authorized Person:

Name:
MR. GENNADY S BABICHENKO
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
122400000X - Denturist
Is Primary:
Yes

Contacts:

Fax:
2083766613

Filing

Filing Name Filing Number Filing date
Initial Filing 0000131093 2000-10-10

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State