Healthcare Provider Details

I. General information

NPI: 1134324296
Provider Name (Legal Business Name): VENT STEPHEN MURPHY D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 LEXINGTON AVE
FORT SMITH AR
72901-4736
US

IV. Provider business mailing address

603 LEXINGTON AVE
FORT SMITH AR
72901-4736
US

V. Phone/Fax

Practice location:
  • Phone: 479-785-5437
  • Fax: 479-785-5534
Mailing address:
  • Phone: 479-785-5437
  • Fax: 479-785-5534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2822
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: