Provider Demographics
NPI:1720027360
Name:MURPHY, MARILYN GOODWIN (DDS)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:GOODWIN
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 1:1923 HARDEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1162
Mailing Address - Country:US
Mailing Address - Phone:478-746-1538
Mailing Address - Fax:478-746-8310
Practice Address - Street 1:1923 HARDEMAN AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1162
Practice Address - Country:US
Practice Address - Phone:478-746-1538
Practice Address - Fax:478-746-8310
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0094271223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry