Healthcare Provider Details

I. General information

NPI: 1790989002
Provider Name (Legal Business Name): DR. JAMES MURRAY DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 PORTLAND ROAD
KENNEBUNK ME
04043
US

IV. Provider business mailing address

PO BOX 1277
KENNEBUNK ME
04043-1277
US

V. Phone/Fax

Practice location:
  • Phone: 207-985-7337
  • Fax: 207-985-7338
Mailing address:
  • Phone: 207-985-7337
  • Fax: 207-985-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number2394
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JAMES METCALFE MURRAY SR.
Title or Position: OWNERORTHODONTIST
Credential: D.D.S
Phone: 207-985-7337