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NPI Code Detail

MEDICARE: DR. MURLIN EDMUND BRALY D.D.S.

MEDICARE: DR. MURLIN EDMUND BRALY D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)3765OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740271469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MURLIN EDMUND BRALY D.D.S.
Provider Business Mailing Address
First Line : PO BOX 269029
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73126-9029
Country : US
Telephone Number : 405-848-7974
Fax Number : 405-848-0033
Provider Business Practice Location Address
First Line : 1201 N STONEWALL AVE # 230
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73117-1214
Country : US
Telephone Number : 405-271-4441
Fax Number : 405-271-1134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 10/30/2019

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