Provider Demographics
NPI:1477799492
Name:MURRAY, MATTHEW DEAN (DDS, MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DEAN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 CEANOTHUS AVE
Mailing Address - Street 2:STE 112
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7721
Mailing Address - Country:US
Mailing Address - Phone:530-343-1685
Mailing Address - Fax:
Practice Address - Street 1:2525 CEANOTHUS AVE
Practice Address - Street 2:STE 112
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7721
Practice Address - Country:US
Practice Address - Phone:530-343-1685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54765122300000X, 1223S0112X
CAA113874204E00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery