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NPI 1477567378

NPI 1477567378 : MURRAY RALPH ROBINOVITCH D.D.S. : MOUNT VERNON, WA

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General NPI Number Information
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    NPI Number           |    1477567378
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    Entity Type          |    Individual 
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    Provider Name        |    MURRAY RALPH ROBINOVITCH D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/28/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2210 KULSHAN VIEW DR STE 105 
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    City                 |    MOUNT VERNON
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    State                |    WA
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    Zip                  |    98273-2779
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    Country              |    US
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    Telephone            |    360-424-5175
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11831 BAYVIEW EDISON RD 
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    City                 |    MOUNT VERNON
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    State                |    WA
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    Zip                  |    98273-8226
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    Country              |    US
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    Telephone            |    360-707-5556
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223P0300X
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    Taxonomy Name        |    Periodontics
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    License Number       |    DE00004887
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    License Number State |    WA
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