Provider Demographics
NPI:1114701281
Name:SUPERDOCK, ANDREW MURPHY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MURPHY
Last Name:SUPERDOCK
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 1:517 STRACKS DAM RD
Mailing Address - Street 2:
Mailing Address - City:MYERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17067-2167
Mailing Address - Country:US
Mailing Address - Phone:717-344-7766
Mailing Address - Fax:
Practice Address - Street 1:320 OAK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6200
Practice Address - Country:US
Practice Address - Phone:717-273-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0442591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty