Provider Demographics
NPI:1457681744
Name:MURPHY, JUDY ANN (RDH)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANN
Other - Last Name:STATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:H6/436 CSC
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-4165
Mailing Address - Country:US
Mailing Address - Phone:608-225-6104
Mailing Address - Fax:608-265-9650
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:H6/436 CSC
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-4165
Practice Address - Country:US
Practice Address - Phone:608-225-6104
Practice Address - Fax:608-265-9650
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3623-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist