Provider Demographics
NPI:1447513361
Name:MURDOCK, NATHAN CHASE (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CHASE
Last Name:MURDOCK
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 1:19 EXECUTIVE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8087
Mailing Address - Country:US
Mailing Address - Phone:740-773-4066
Mailing Address - Fax:740-773-9174
Practice Address - Street 1:225 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:UT
Practice Address - Zip Code:84713-7712
Practice Address - Country:US
Practice Address - Phone:435-421-9193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0237531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice