Provider Demographics
NPI:1245387497
Name:MURRAY, SHAWN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 BRUNNER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-7492
Mailing Address - Country:US
Mailing Address - Phone:970-587-1043
Mailing Address - Fax:
Practice Address - Street 1:257 JOHNSTOWN CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-7846
Practice Address - Country:US
Practice Address - Phone:970-443-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics