Provider Demographics
NPI:1376613505
Name:SPAIN, MURRAY JR (DMD)
Entity type:Individual
Prefix:
First Name:MURRAY
Middle Name:
Last Name:SPAIN
Suffix:JR
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 1:3634 SOUTH PLZA TRAIL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452
Mailing Address - Country:US
Mailing Address - Phone:757-498-9510
Mailing Address - Fax:757-498-6943
Practice Address - Street 1:1119 W CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:SC
Practice Address - Zip Code:29702-9221
Practice Address - Country:US
Practice Address - Phone:864-839-0034
Practice Address - Fax:864-839-0064
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070061223G0001X
SC27611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice