Mruk, James G

Mruk, James G is an individual health care provider with primary practice located at 11 School St , Randolph NY 14772-1103. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mruk, James G can be contacted via phone (716) 358-6001.

Contact Information

Primary practice address
11 School St Randolph NY 14772-1103
Phone: (716) 358-6001
Fax: (716) 358-6011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 26075 New York

Profile Details

NPI number 1174623359
LBN Legal business name Mruk, James G
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 8th, 2007 - about 18 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 1174623359 NPPES
New York MEDICAID 00981902
New York Other 000770077001
New York Other 584157

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