Provider Demographics
NPI:1235342668
Name:MURDOCK, JOHN EDMON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDMON
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 ARINGILL LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8043
Mailing Address - Country:US
Mailing Address - Phone:919-260-7403
Mailing Address - Fax:
Practice Address - Street 1:727 GILLSBROOK RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-1817
Practice Address - Country:US
Practice Address - Phone:803-285-7923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6901223X0400X
NC80141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics