Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN009082 | GA |
NPI | 1669473773 |
---|---|
Provider Name | Dr. Michael Raymond Murden |
First Address | Dahlonega, GA 30533-7924 |
Second Address | Gainesville, GA 30507-7000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 14/08/2007 |