| Martin Ruelas, Dmd, Pc | |
|
10330 N Juliet Ct Peoria IL 61615-1199 | |
| (309) 243-8455 | |
| (309) 243-8466 |
| Full Name | Martin Ruelas, Dmd, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10330 N Juliet Ct, Peoria, Illinois |
| Authorized Official Name and Position | Martin Ruelas (DENTIST) |
| Authorized Official Contact | 3092438455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Ruelas, Dmd, Pc Po Box 9423 Peoria IL 61612-9423 Ph: () - | Martin Ruelas, Dmd, Pc 10330 N Juliet Ct Peoria IL 61615-1199 Ph: (309) 243-8455 |
| NPI Number | 1104098078 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 03/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104098078 | NPI | - | NPPES |
| 1035425/1004935 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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