Provider Demographics
NPI:1265506968
Name:MULLINS, JOHN ELVERAGE JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ELVERAGE
Last Name:MULLINS
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:PO BOX 839
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-0839
Mailing Address - Country:US
Mailing Address - Phone:908-490-0560
Mailing Address - Fax:908-490-0562
Practice Address - Street 1:567 PARK AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1754
Practice Address - Country:US
Practice Address - Phone:908-490-0560
Practice Address - Fax:908-490-0562
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NJ0183671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery