Provider Demographics
NPI:1104046614
Name:MURDOCH, HUGH JOHN (DDS MS)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:JOHN
Last Name:MURDOCH
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6519 NICOLLET AVENUE SOUTH
Mailing Address - Street 2:SUITE 304
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423
Mailing Address - Country:US
Mailing Address - Phone:612-866-9900
Mailing Address - Fax:612-866-9362
Practice Address - Street 1:6519 NICOLLET AVENUE SOUTH
Practice Address - Street 2:SUITE 304
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423
Practice Address - Country:US
Practice Address - Phone:612-866-9900
Practice Address - Fax:612-866-9362
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND118301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics