Provider Demographics
NPI:1053473264
Name:MURPHY, PATRICK J (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 CENTRAL AVE N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1206
Mailing Address - Country:US
Mailing Address - Phone:952-473-9779
Mailing Address - Fax:952-473-9570
Practice Address - Street 1:250 CENTRAL AVE N
Practice Address - Street 2:SUITE 300
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1206
Practice Address - Country:US
Practice Address - Phone:952-473-9779
Practice Address - Fax:952-473-9570
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN70441223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics