MEDICARE: DR. MICHAEL RAYMOND MURDEN D.D.S.

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	1223D0001X	Public Health Dentistry	DN009082	GA

General Provider Information

NPI Number	:	1669473773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL RAYMOND MURDEN D.D.S.

Provider Business Mailing Address
First Line	:	5204 HIGHWAY 19 N
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533-7924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1280 ATHENS ST
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30507-7000
Country	:	US
Telephone Number	:	770-535-5881
Fax Number	:	770-535-5958

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	08/14/2007

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Directions to “ DR. MICHAEL RAYMOND MURDEN D.D.S.” Practice Location

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