Provider Demographics
NPI:1366598906
Name:MURPHY, DAVID A (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILMORE
Mailing Address - State:KY
Mailing Address - Zip Code:40390
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:859-858-4684
Practice Address - Street 1:113 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMORE
Practice Address - State:KY
Practice Address - Zip Code:40390
Practice Address - Country:US
Practice Address - Phone:859-858-3335
Practice Address - Fax:859-858-4684
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60048782Medicaid