Provider Demographics
NPI:1669508123
Name:MURNI, RUSDY (DDS)
Entity Type:Individual
Prefix:
First Name:RUSDY
Middle Name:
Last Name:MURNI
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 1:198 E ELM ST
Mailing Address - Street 2:STE 103
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210
Mailing Address - Country:US
Mailing Address - Phone:559-935-2368
Mailing Address - Fax:559-935-2368
Practice Address - Street 1:198 E ELM ST
Practice Address - Street 2:STE 103
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210
Practice Address - Country:US
Practice Address - Phone:559-935-2368
Practice Address - Fax:559-935-2368
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40968122300000X
OR6978122300000X
TX244181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice