Provider Demographics
NPI:1649344847
Name:MURO, THOMAS JR (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MURO
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 1:13550 SW 120TH ST
Mailing Address - Street 2:512
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7397
Mailing Address - Country:US
Mailing Address - Phone:305-380-7000
Mailing Address - Fax:786-227-5315
Practice Address - Street 1:13550 SW 120TH ST
Practice Address - Street 2:512
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7397
Practice Address - Country:US
Practice Address - Phone:305-380-7000
Practice Address - Fax:786-227-5315
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00137491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
477OtherMCNA
282317OtherTRIGON BCBS
242731OtherDENTAL BENEFITS PROVIDER
FL071029600Medicaid
4083OtherCOMP BENEFITS
980638OtherUNITED CONCORDIA
69943OtherBCBS
10061OtherUNIVERSAL II