Provider Demographics
NPI:1275222432
Name:THE CENTRE FOR ORAL SURGERY IN JOLIET, INC.
Entity Type:Organization
Organization Name:THE CENTRE FOR ORAL SURGERY IN JOLIET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF DENTAL SURGERY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BABIUK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-324-4470
Mailing Address - Street 1:6501 CITY WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3248
Mailing Address - Country:US
Mailing Address - Phone:952-653-2525
Mailing Address - Fax:
Practice Address - Street 1:1404 AQUARIUS CIR STE A
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-8914
Practice Address - Country:US
Practice Address - Phone:815-324-4470
Practice Address - Fax:815-324-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site