Healthcare Provider Details

I. General information

NPI: 1669989257
Provider Name (Legal Business Name): EMILY S MURRAY DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 E 98TH ST STE 121
INDIANAPOLIS IN
46280-1973
US

IV. Provider business mailing address

3003 E 98TH ST STE 121
INDIANAPOLIS IN
46280-1973
US

V. Phone/Fax

Practice location:
  • Phone: 317-844-0067
  • Fax: 317-844-0527
Mailing address:
  • Phone: 317-844-0067
  • Fax: 317-844-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number12012745A
License Number StateIN

VIII. Authorized Official

Name: DR. EMILY SUZANNE MURRAY
Title or Position: DDS
Credential: DDS
Phone: 317-844-0067