Healthcare Provider Details

I. General information

NPI: 1619000627
Provider Name (Legal Business Name): ROBERT M MRAULE DDS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 PAJARO ST
SALINAS CA
93901-2925
US

IV. Provider business mailing address

1124 PAJARO ST
SALINAS CA
93901-2925
US

V. Phone/Fax

Practice location:
  • Phone: 831-757-3021
  • Fax: 831-757-5833
Mailing address:
  • Phone: 831-757-3021
  • Fax: 831-757-5833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberG36671
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT M MRAULE
Title or Position: PRESIDENT
Credential: MD
Phone: 831-757-3021