Provider Demographics
NPI:1831668565
Name:STEPHEN T. HICKS AND M. BANCROFT MCMURPHY III DDS PC
Entity Type:Organization
Organization Name:STEPHEN T. HICKS AND M. BANCROFT MCMURPHY III DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M. BANCROFT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMURPHY
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:251-660-7434
Mailing Address - Street 1:1575 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2958
Mailing Address - Country:US
Mailing Address - Phone:251-660-7434
Mailing Address - Fax:251-660-9972
Practice Address - Street 1:1575 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2958
Practice Address - Country:US
Practice Address - Phone:251-660-7434
Practice Address - Fax:251-660-9972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty