Provider Demographics
NPI:1851452197
Name:MURPHY, MARK KENNETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:KENNETH
Last Name:MURPHY
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 1:23136 BIRCHWOOD ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-4516
Mailing Address - Country:US
Mailing Address - Phone:218-739-6264
Mailing Address - Fax:
Practice Address - Street 1:1409 COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1055
Practice Address - Country:US
Practice Address - Phone:218-739-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN95331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice