MEDICARE: DR. JILL K BABINEC D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	20711	OH

General Provider Information

NPI Number	:	1437152428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL K BABINEC D.D.S.

Provider Business Mailing Address
First Line	:	15 LIBERTY ST
Second Line	:
City	:	NORTH JACKSON
State	:	OH
Zip	:	44451-8706
Country	:	US
Telephone Number	:	330-792-5560
Fax Number	:	330-538-3305

Provider Business Practice Location Address
First Line	:	15 LIBERTY ST
Second Line	:
City	:	NORTH JACKSON
State	:	OH
Zip	:	44451
Country	:	US
Telephone Number	:	330-538-3304
Fax Number	:	330-538-3305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/02/2019

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