Provider Demographics
NPI:1891147443
Name:MURDZA, MICHAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:
Last Name:MURDZA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S WE GO TRL
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2959
Mailing Address - Country:US
Mailing Address - Phone:773-428-6001
Mailing Address - Fax:
Practice Address - Street 1:5447 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-1820
Practice Address - Country:US
Practice Address - Phone:773-763-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.030682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist