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Individual

DR. RUSSELL A MURPHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1329 N IRONWOOD DRIVE, SOUTH BEND, IN 46615-3566
(574) 271-7500
(574) 271-6052
Mailing address
1329 N IRONWOOD DRIVE, SOUTH BEND, IN 46615-3566
(574) 271-7500
(574) 271-6052

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010061A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200205420B
IN
Enumeration date
11/16/2006
Last updated
03/07/2013
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