Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 54765 | CA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 54765 | CA |
N | 204E00000X | Oral & Maxillofacial Surgeon | A113874 | CA |
N | 208200000X | Surgeon | A113874 | CA |
N | 208600000X | Surgeon | A113874 | CA |
NPI | 1477799492 |
---|---|
Provider Name | Matthew Dean Murray |
First Address | Chico, CA 95973-7721 |
Second Address | Chico, CA 95973-7721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2008 |
Last Update Date | 02/02/2017 |