Provider Demographics
NPI:1306825427
Name:MURRELL, STEPHEN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:MURRELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:STEPHEN
Other - Middle Name:P
Other - Last Name:MURRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:18414 WEST MAUNA LOA LANE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388
Mailing Address - Country:US
Mailing Address - Phone:661-886-9537
Mailing Address - Fax:
Practice Address - Street 1:18414 WEST MAUNA LOA LANE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388
Practice Address - Country:US
Practice Address - Phone:661-886-9537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2990122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD009698OtherDENTIST TRIENNIAL CERTFICATE OF RENEWAL
ME2990OtherDENTIST LICENSE NUMBER