Provider Demographics
NPI:1497067656
Name:MURRAY, BRADLEY M (DMD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:BRAD
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2221 W LEDBETTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-4713
Mailing Address - Country:US
Mailing Address - Phone:214-234-8444
Mailing Address - Fax:214-234-8448
Practice Address - Street 1:2221 W LEDBETTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-4713
Practice Address - Country:US
Practice Address - Phone:214-234-8444
Practice Address - Fax:214-234-8448
Is Sole Proprietor?:No
Enumeration Date:2010-07-04
Last Update Date:2010-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist