Provider Demographics
NPI:1356498943
Name:MACMURDO, ROBERT C (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:MACMURDO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 EVANS DR
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-1418
Mailing Address - Country:US
Mailing Address - Phone:724-752-8989
Mailing Address - Fax:
Practice Address - Street 1:216 EVANS DR
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-1418
Practice Address - Country:US
Practice Address - Phone:724-752-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029113-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice