Provider Demographics
NPI:1316163041
Name:MURRAY, VINCENT JOHN (DDS)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:JOHN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ROCK POINTE LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2632
Mailing Address - Country:US
Mailing Address - Phone:540-349-0056
Mailing Address - Fax:540-349-0013
Practice Address - Street 1:1209 N FRASER ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-2853
Practice Address - Country:US
Practice Address - Phone:435-462-2738
Practice Address - Fax:843-546-7777
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5415724691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice