Mirkin, Craig

Mirkin, Craig is an individual health care provider with primary practice located at 3415 28Th St , Port Huron MI 48060-6931. He recently has only one registered license in Dental Providers / Dental Public Health, which is considered as his primary health care specialty. Mirkin, Craig can be contacted via phone (810) 984-5197.

Contact Information

Primary practice address
3415 28Th St Port Huron MI 48060-6931
Phone: (810) 984-5197
Fax: (810) 985-2150
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X 2901011180 Michigan

Profile Details

NPI number 1003983677
LBN Legal business name Mirkin, Craig
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003983677 NPPES
Michigan MEDICAID 4046170

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