Provider Demographics
NPI:1790786143
Name:MURRAY, KENNETH ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:ALAN
Last Name:MURRAY
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 1:675 ORCHARD HEIGHTS RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3186
Mailing Address - Country:US
Mailing Address - Phone:503-370-8787
Mailing Address - Fax:503-585-9559
Practice Address - Street 1:675 ORCHARD HEIGHTS RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3186
Practice Address - Country:US
Practice Address - Phone:503-370-8787
Practice Address - Fax:503-585-9559
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5977122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist