Healthcare Provider Details

I. General information

NPI: 1487811428
Provider Name (Legal Business Name): WILLIAM U MURTHY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1867 E HIGH ST
POTTSTOWN PA
19464-3294
US

IV. Provider business mailing address

1301 PENN AVE
WYOMISSING PA
19610-2140
US

V. Phone/Fax

Practice location:
  • Phone: 610-327-0888
  • Fax:
Mailing address:
  • Phone: 610-372-6313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS035531
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: