Healthcare Provider Details

I. General information

NPI: 1730255498
Provider Name (Legal Business Name): DR. WALTER K. MURPHY, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7009 LEE DAVIS ROAD
MECHANICSVILLE VA
23111
US

IV. Provider business mailing address

7009 LEE DAVIS ROAD
MECHANICSVILLE VA
23111
US

V. Phone/Fax

Practice location:
  • Phone: 804-746-1864
  • Fax: 804-746-4158
Mailing address:
  • Phone: 804-746-1864
  • Fax: 804-746-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number0401006869
License Number StateVA

VIII. Authorized Official

Name: DR. WALTER K. MURPHY
Title or Position: OWNER
Credential: DDS
Phone: 804-746-1864