Provider Demographics
NPI:1326106394
Name:MURPHY, GREGORY NOAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:NOAL
Last Name:MURPHY
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 1:2819 28TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5422
Mailing Address - Country:US
Mailing Address - Phone:309-793-5169
Mailing Address - Fax:
Practice Address - Street 1:2501 24TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5300
Practice Address - Country:US
Practice Address - Phone:309-788-3398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019016729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist