Provider Demographics
NPI:1073193199
Name:MURRAY, JODI (RDH)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 ELYSIUM AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7448
Mailing Address - Country:US
Mailing Address - Phone:541-554-3213
Mailing Address - Fax:
Practice Address - Street 1:2320 ELYSIUM AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7448
Practice Address - Country:US
Practice Address - Phone:541-554-3213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No124Q00000XDental ProvidersDental Hygienist