Provider Demographics
NPI:1992828875
Name:MURAT, MICHAEL COREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:COREY
Last Name:MURAT
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 1:1915 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3390
Mailing Address - Country:US
Mailing Address - Phone:541-296-5677
Mailing Address - Fax:541-296-4153
Practice Address - Street 1:1915 E 19TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3390
Practice Address - Country:US
Practice Address - Phone:541-296-5677
Practice Address - Fax:541-296-4153
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD62381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice