National Provider Identifier
James G Mruk, DDS
James G Mruk, DDS is listed in the NPPES registry with a primary specialty of Dentist in Randolph, NY and a listed phone number of (716) 358-6001.
Profile Overview
- NPI
- 1174623359
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- September 25, 2006
- Last Updated
- July 08, 2007
Practice Location
- 11 School St
- Randolph, NY 14772-1103
Phone: (716) 358-6001
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1174623359
- Entity Type
- Individual
- Last Name
- Mruk
- First Name
- James
- Middle Name
- G
- Credential
- DDS
- Mailing Street Address
- 11 School St
- Mailing City
- Randolph
- Mailing State
- NY
- Mailing ZIP Code
- 14772-1103
- Mailing Country
- US
- Mailing Phone
- (716) 358-6001
- Mailing Fax
- (716) 358-6011
- Practice Street Address
- 11 School St
- Practice City
- Randolph
- Practice State
- NY
- Practice ZIP Code
- 14772-1103
- Practice Country
- US
- Practice Phone
- (716) 358-6001
- Practice Fax
- (716) 358-6011
- Enumeration Date
- September 25, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)
- Other Identifiers
- 00981902 (NY), 000770077001 (NY, Child Health Care Plus), 584157 (NY, United Concordia Ins)