Provider Demographics
NPI:1275748782
Name:MURRAY SPAIN,JR.,DMD
Entity Type:Organization
Organization Name:MURRAY SPAIN,JR.,DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTISTRY
Authorized Official - Prefix:
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-625-1817
Mailing Address - Street 1:1216 GRANBY ST
Mailing Address - Street 2:2
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MUARRY SPAIN,JR.,D.M.D1216 GRANBY ST
Practice Address - Street 2:2
Practice Address - City:NORFOK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-625-1817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty