Provider Demographics
NPI:1659578755
Name:MURPHY, MARTHA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LAKEFOREST BLVD
Mailing Address - Street 2:SUITE 620
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877
Mailing Address - Country:US
Mailing Address - Phone:301-990-7778
Mailing Address - Fax:301-990-8808
Practice Address - Street 1:100 LAKEFOREST BLVD
Practice Address - Street 2:SUITE 620
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2609
Practice Address - Country:US
Practice Address - Phone:301-990-7778
Practice Address - Fax:301-990-8808
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD77351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice