Provider Demographics
NPI:1679697254
Name:MURPHY, MARC ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:ALAN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 E 82ND STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-4516
Mailing Address - Country:US
Mailing Address - Phone:317-849-5898
Mailing Address - Fax:317-849-5901
Practice Address - Street 1:5519 E 82ND STREET
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4516
Practice Address - Country:US
Practice Address - Phone:317-849-5898
Practice Address - Fax:317-849-5901
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120093651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice