Provider Demographics
NPI:1407056385
Name:DR. MICHAEL A. KUBINIEC DDS
Entity Type:Organization
Organization Name:DR. MICHAEL A. KUBINIEC DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:KUBINIEC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-343-5865
Mailing Address - Street 1:180 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2113
Mailing Address - Country:US
Mailing Address - Phone:585-343-5865
Mailing Address - Fax:585-343-5719
Practice Address - Street 1:180 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2113
Practice Address - Country:US
Practice Address - Phone:585-343-5865
Practice Address - Fax:585-343-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041012305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service