Provider Demographics
NPI:1922648047
Name:JOHN A. MURRELL, DDS, PLLC DBA RALEIGH PROSTHODONTICS
Entity Type:Organization
Organization Name:JOHN A. MURRELL, DDS, PLLC DBA RALEIGH PROSTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ABBOTT
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-510-4959
Mailing Address - Street 1:2605 BLUE RIDGE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6475
Mailing Address - Country:US
Mailing Address - Phone:919-510-4959
Mailing Address - Fax:
Practice Address - Street 1:2605 BLUE RIDGE RD STE 310
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6475
Practice Address - Country:US
Practice Address - Phone:919-510-4959
Practice Address - Fax:919-510-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1831508431OtherINDIVDUAL NPI - HUGH MURPHY
NC1750551297OtherINDIVIDUAL NPI- JOHN A. MURRELL