Healthcare Provider Details

I. General information

NPI: 1932147451
Provider Name (Legal Business Name): VENT S MURPHY DDS MS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 LEXINGTON AVE
FORT SMITH AR
72901
US

IV. Provider business mailing address

603 LEXINGTON AVE
FORT SMITH AR
72901
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 NumberARK 2822
License Number StateAR

VIII. Authorized Official

Name: MR. VENT S MURPHY
Title or Position: OWNER
Credential: DDS MS
Phone: 479-785-5437