Provider Demographics
NPI:1508806415
Name:MURRELL, KEVIN P (DDS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:P
Last Name:MURRELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54951 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-6028
Mailing Address - Country:US
Mailing Address - Phone:586-677-9099
Mailing Address - Fax:586-677-9096
Practice Address - Street 1:54951 MOUND RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-6028
Practice Address - Country:US
Practice Address - Phone:586-677-9099
Practice Address - Fax:586-677-9096
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI015342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist