Provider Demographics
NPI:1770983645
Name:DR. ROBERT MURRAY DDS
Entity type:Organization
Organization Name:DR. ROBERT MURRAY DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-945-5112
Mailing Address - Street 1:1512 GRAND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3845
Mailing Address - Country:US
Mailing Address - Phone:970-945-5112
Mailing Address - Fax:
Practice Address - Street 1:1512 GRAND AVE STE 202
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3845
Practice Address - Country:US
Practice Address - Phone:970-945-5112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty