Provider Demographics
NPI:1386094704
Name:MCMURPHY, AMANDA TODD (DMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:TODD
Last Name:MCMURPHY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 BAY BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-5550
Mailing Address - Country:US
Mailing Address - Phone:601-604-1578
Mailing Address - Fax:
Practice Address - Street 1:2318 PASS RD STE 9
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4044
Practice Address - Country:US
Practice Address - Phone:228-207-1548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3856-161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice