Provider Demographics
NPI:1184955825
Name:MURTAUGH DENTAL, PC
Entity type:Organization
Organization Name:MURTAUGH DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GINNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-389-2905
Mailing Address - Street 1:2590 NE COURTNEY DR
Mailing Address - Street 2:STE. 2
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7640
Mailing Address - Country:US
Mailing Address - Phone:541-389-2905
Mailing Address - Fax:541-389-2936
Practice Address - Street 1:2590 NE COURTNEY DR
Practice Address - Street 2:STE. 2
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7640
Practice Address - Country:US
Practice Address - Phone:541-389-2905
Practice Address - Fax:541-389-2936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD85591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty