Provider Demographics
NPI:1912113838
Name:MURTAUGH, VIRGINIA KAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:KAY
Last Name:MURTAUGH
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 1:1510 SW NANCY WAY
Mailing Address - Street 2:SUITE #2
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3256
Mailing Address - Country:US
Mailing Address - Phone:541-322-0444
Mailing Address - Fax:541-322-0195
Practice Address - Street 1:1510 SW NANCY WAY
Practice Address - Street 2:SUITE #2
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3256
Practice Address - Country:US
Practice Address - Phone:541-322-0444
Practice Address - Fax:541-322-0195
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD85591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice