Provider Demographics
NPI:1336647924
Name:MURPHREE'S SMILE DESIGNERS
Entity Type:Organization
Organization Name:MURPHREE'S SMILE DESIGNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-842-7154
Mailing Address - Street 1:602 PEGRAM DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6322
Mailing Address - Country:US
Mailing Address - Phone:662-384-7154
Mailing Address - Fax:662-842-5698
Practice Address - Street 1:602 PEGRAM DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6322
Practice Address - Country:US
Practice Address - Phone:662-384-7154
Practice Address - Fax:662-842-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental