Healthcare Provider Details

I. General information

NPI: 1639159734
Provider Name (Legal Business Name): DAVID FRANKLIN MURCHISON DDS, MMS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BERGQUIST DR ATTN: CREDENTIALS (CMC), SUITE 1
LACKLAND AFB TX
78236-5300
US

IV. Provider business mailing address

15711 LUNA RDG
HELOTES TX
78023-4718
US

V. Phone/Fax

Practice location:
  • Phone: 210-292-6280
  • Fax: 210-292-2618
Mailing address:
  • Phone: 210-695-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2665
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: