Provider Demographics
NPI:1093104259
Name:SMITH, MURRAY STEPHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:STEPHEN
Last Name:SMITH
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 1:255 SONOMA LN
Mailing Address - Street 2:PO BOX 332
Mailing Address - City:MARTINSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16662-8156
Mailing Address - Country:US
Mailing Address - Phone:814-793-2275
Mailing Address - Fax:
Practice Address - Street 1:255 SONOMA LN
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:PA
Practice Address - Zip Code:16662-8156
Practice Address - Country:US
Practice Address - Phone:814-793-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019970-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice