Provider Demographics
NPI:1720473911
Name:MURRAY, LESLIE MEGAN (DMD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:MEGAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 IVANHOE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3904
Mailing Address - Country:US
Mailing Address - Phone:970-759-4915
Mailing Address - Fax:704-355-8856
Practice Address - Street 1:3545 QUEBEC ST STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-1603
Practice Address - Country:US
Practice Address - Phone:970-759-4915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAC5385578-R11121223G0001X
CODEN.002041851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice