Healthcare Provider Details

I. General information

NPI: 1780708339
Provider Name (Legal Business Name): GBUREK BARONE & KUPKA DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 DUNCAN ST
WARSAW NY
14569-1017
US

IV. Provider business mailing address

34 DUNCAN ST
WARSAW NY
14569-1017
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-3676
  • Fax: 585-786-3896
Mailing address:
  • Phone: 585-786-3676
  • Fax: 585-786-3896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL R GBUREK
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 585-786-3676