Provider Demographics
NPI:1952707580
Name:MCMURRAY AND GILL DENTAL CORPORATION
Entity Type:Organization
Organization Name:MCMURRAY AND GILL DENTAL CORPORATION
Other - Org Name:CHAMPLAIN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCMURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-433-6427
Mailing Address - Street 1:17000 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5626
Mailing Address - Country:US
Mailing Address - Phone:714-845-8890
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:1193 E CHAMPLAIN DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-5010
Practice Address - Country:US
Practice Address - Phone:559-433-6427
Practice Address - Fax:559-433-6429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty