Provider Demographics
NPI:1619995735
Name:MURPHY, KEVIN MICHAEL (DDS, MS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MICHAEL
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 N CHARLES ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-1756
Mailing Address - Country:US
Mailing Address - Phone:410-235-1233
Mailing Address - Fax:410-235-1286
Practice Address - Street 1:3900 N CHARLES ST
Practice Address - Street 2:SUITE 112
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-1756
Practice Address - Country:US
Practice Address - Phone:410-235-1233
Practice Address - Fax:410-235-1286
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD78501223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics