Provider Demographics
NPI:1972865269
Name:MURPHY MAXILLOFACIAL SURGERY PLLC
Entity Type:Organization
Organization Name:MURPHY MAXILLOFACIAL SURGERY PLLC
Other - Org Name:MURPHY OMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:970-420-6848
Mailing Address - Street 1:1136 E STUART ST
Mailing Address - Street 2:SUITE 3-240
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1195
Mailing Address - Country:US
Mailing Address - Phone:970-420-6848
Mailing Address - Fax:970-682-2183
Practice Address - Street 1:1136 E STUART ST
Practice Address - Street 2:SUITE 3-240
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1195
Practice Address - Country:US
Practice Address - Phone:970-420-6848
Practice Address - Fax:970-682-2183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101541223S0112X
CO51252204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty