Provider Demographics
NPI:1447439278
Name:MURPHEY, GRIFFIN TAYLOR (DDS)
Entity type:Individual
Prefix:DR
First Name:GRIFFIN
Middle Name:TAYLOR
Last Name:MURPHEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 SOUTH LAKE STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104
Mailing Address - Country:US
Mailing Address - Phone:817-335-9440
Mailing Address - Fax:817-335-9445
Practice Address - Street 1:1124 SOUTH LAKE STREET
Practice Address - Street 2:SUITE D
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104
Practice Address - Country:US
Practice Address - Phone:817-335-9440
Practice Address - Fax:817-335-9445
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice