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NPI Code Detail

MEDICARE: LISA MARIE MURPHY RDH

MEDICARE: LISA MARIE MURPHY RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist6025AZ

General Provider Information

NPI Number : 1053420687
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE MURPHY RDH
Provider Business Mailing Address
First Line : PO BOX 1566
Second Line :
City : PINE
State : AZ
Zip : 85544-1566
Country : US
Telephone Number : 928-476-4054
Fax Number :
Provider Business Practice Location Address
First Line : 300 W AIRPORT RD
Second Line :
City : PAYSON
State : AZ
Zip : 85541-3607
Country : US
Telephone Number : 928-474-3216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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Directions to “ LISA MARIE MURPHY RDH” Practice Location

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