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General NPI Number Information
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NPI Number | 1275748782
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Entity Type | Organization
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Legal Business Name | MURRAY SPAIN,JR.,DMD
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | MUARRY SPAIN,JR.,D.M.D1216 GRANBY ST 2
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City | NORFOK
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State | VA
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Zip | 23510
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Country | US
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Telephone | 757-625-1817
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 GRANBY ST 2
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City | NORFOLK
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State | VA
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Zip | 23510-2607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTISTRY
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Name | MURRAY SPAIN
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Credential |
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Telephone | 757-625-1817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401007006
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License Number State | VA
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