Provider Demographics
NPI:1427207034
Name:MURPHY, MARIAH L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIAH
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E MAIN ST
Mailing Address - Street 2:PO BOX 71
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1427
Mailing Address - Country:US
Mailing Address - Phone:920-849-9341
Mailing Address - Fax:920-849-9342
Practice Address - Street 1:15 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-1427
Practice Address - Country:US
Practice Address - Phone:920-849-9341
Practice Address - Fax:920-849-9342
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5360-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice