MEDICARE: DONALD R MURDOCK DMD MS

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	19392	OH

General Provider Information

NPI Number	:	1437219961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD R MURDOCK DMD MS

Provider Business Mailing Address
First Line	:	5420 NORTH BEND RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247
Country	:	US
Telephone Number	:	513-662-2100
Fax Number	:	513-662-7313

Provider Business Practice Location Address
First Line	:	5420 NORTH BEND RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247
Country	:	US
Telephone Number	:	513-662-2100
Fax Number	:	513-662-7313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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