Individual
SHANE T. MURPHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
330 E TUDOR RD, ANCHORAGE, AK 99503-7369
(907) 561-4047
(907) 562-9856
Mailing address
330 E TUDOR RD, ANCHORAGE, AK 99503-7369
(907) 561-4047
(907) 562-9856
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1131
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630417
UNITED CONCORDIA PROVIDER
AK
01
—
1131
DENTAL LICENSE #
AK
05
—
DD1741
—
AK
Enumeration date
07/13/2006
Last updated
03/07/2023
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