MEDICARE: RONALD LABINSKI DDS

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	122300000X	Dentist	W1600	WI

General Provider Information

NPI Number	:	1578707329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD LABINSKI DDS

Provider Business Mailing Address
First Line	:	3787 S LUCYLLE LN
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53146-2911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3787 S LUCYLLE LN
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53146-2911
Country	:	US
Telephone Number	:	262-547-2334
Fax Number	:

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

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/23/2009

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