Provider Demographics
NPI:1063834208
Name:SHAWN M MURRAY DDS MS PC
Entity Type:Organization
Organization Name:SHAWN M MURRAY DDS MS PC
Other - Org Name:MURRAY ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-330-5363
Mailing Address - Street 1:1825 56TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3028
Mailing Address - Country:US
Mailing Address - Phone:970-330-5363
Mailing Address - Fax:970-330-5451
Practice Address - Street 1:1825 56TH AVE STE A
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3028
Practice Address - Country:US
Practice Address - Phone:970-330-5363
Practice Address - Fax:970-330-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty