Provider Demographics
NPI:1801912183
Name:MURPHY, LUKE B (DMD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:B
Last Name:MURPHY
Suffix:
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:PO BOX 1150
Mailing Address - Street 2:21300 HIGHWAY 62
Mailing Address - City:SHADY COVE
Mailing Address - State:OR
Mailing Address - Zip Code:97539-1150
Mailing Address - Country:US
Mailing Address - Phone:541-878-2115
Mailing Address - Fax:541-878-2117
Practice Address - Street 1:21300 HWY 62
Practice Address - Street 2:
Practice Address - City:SHADY COVE
Practice Address - State:OR
Practice Address - Zip Code:97539-9717
Practice Address - Country:US
Practice Address - Phone:541-878-2115
Practice Address - Fax:541-878-2117
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8765122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist