Mark John Bruzek in Hermantown - Pediatric Dentistry
Mark John Bruzek - NPI 1568687044
Mark John Bruzek is a Pediatric Dentistry in Hermantown, Minnesota. Mark John Bruzek practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Mark John Bruzek is 1568687044. The last update date is 2013-07-30.
Mark John Bruzek's current location address is 4419 Air Base Road, Hermantown, Minnesota. You can contact this provider via phone number 2187282117 and fax number 2187282700. The mailing address for Mark John Bruzek is 4419 Air Base Road, Hermantown, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark John Bruzek |
|---|---|
| Address | 4419 Air Base Road, Hermantown, Minnesota |
| Phone Number | 2187282117 |
| Fax Number | 2187282700 |
| Sole Proprietor | N |
| Credentials | D.D.S., M. |
NPI Number Detail
| NPI Number | 1568687044 |
|---|---|
| Provider Enumeration Date | 2007-04-17 |
| Last Updated Date | 2013-07-30 |
Provider Mailing Address Detail
| Address | 4419 Air Base Road |
|---|---|
| City | Hermantown |
| State | Minnesota (MN) |
| Post Code | 55811 |
| Phone Number | 2187282117 |
| Fax Number | 2187282700 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 3444 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33473800 | WI | -- | |
| 3444 | WI | DELTA DENTAL WI ID# |
Post Comment/ Review Below
What is the Mark John Bruzek's 1568687044?
The Mark John Bruzek's NPI (National Provider Identifier) Number is 1568687044. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Mark John Bruzek?
The Mark John Bruzek is situated at 4419 Air Base Road, in the city of Hermantown, state of MN, with the zip code 55811.
What is Mark John Bruzek's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mark John Bruzek is Pediatric Dentistry, and the taxonomy classification code that categorizes this area of expertise is 1223P0221X.
On what date was the 1568687044 assigned to Mark John Bruzek?
The Mark John Bruzek was issued its 1568687044 on 2007-04-17, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Mark John Bruzek most recently updated or refreshed?
The details pertaining to the Mark John Bruzek, including its address, specialty, and other relevant information, were last updated or refreshed on 2013-07-30.