Healthcare Provider Details
I. General information
NPI: 1972802494
Provider Name (Legal Business Name): DENNIS M MURPHY DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2011
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
310 TERRACE AVE SUITE 102
CINCINNATI OH
45220-2078
US
IV. Provider business mailing address
310 TERRACE AVE SUITE 102
CINCINNATI OH
45220-2078
US
V. Phone/Fax
- Phone: 513-221-1550
- Fax: 513-221-3170
- Phone: 513-221-1550
- Fax: 513-221-3170
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | 15492 |
| License Number State | OH |
VIII. Authorized Official
Name: DR.
DENNIS
M
MURPHY
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 513-221-1550