Provider Demographics
NPI:1497719900
Name:BABUREK, JAMES MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MATTHEW
Last Name:BABUREK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4230
Mailing Address - Country:US
Mailing Address - Phone:419-475-3494
Mailing Address - Fax:419-475-8896
Practice Address - Street 1:4154 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4230
Practice Address - Country:US
Practice Address - Phone:419-475-3494
Practice Address - Fax:419-475-8896
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30 0217391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice