Martin Ruelas, Dmd, Pc

LBN: Martin Ruelas, Dmd, Pc
Martin Ruelas, Dmd, Pc is an health care organization with primary practice located at 10330 N Juliet Ct , Peoria IL 61615-1199. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Martin Ruelas, Dmd, Pc can be contacted via phone (309) 243-8455, or through Ruelas, Martin via phone (309) 243-8455.

Contact Information

Primary practice address
10330 N Juliet Ct Peoria IL 61615-1199
Phone: (309) 243-8455
Fax: (309) 243-8466
Website:
Map and Directions
Authorized official contact:
Name: Ruelas, Martin Doctor of Dental Medicine (DMD)
Phone: (309) 243-8455

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1104098078
LBN Legal business name Martin Ruelas, Dmd, Pc
DBA Doing business as
Authorized official Ruelas, Martin Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2008
Last updated Mar 31st, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1104098078 NPPES
Illinois MEDICAID 1035425/1004935

Popular Providers