Provider Demographics
NPI:1881704690
Name:JOHNSON, MURRAY (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 MAIN ST
Mailing Address - Street 2:CAPE PEDIATRIC DENTAL ASSOCIATES, PC
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2751
Mailing Address - Country:US
Mailing Address - Phone:508-432-7555
Mailing Address - Fax:
Practice Address - Street 1:719 MAIN ST
Practice Address - Street 2:CAPE PEDIATRIC DENTAL ASSOCIATES, PC
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2751
Practice Address - Country:US
Practice Address - Phone:508-432-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry