Healthcare Provider Details

I. General information

NPI: 1093643637
Provider Name (Legal Business Name): MURRAY AND MAZUR DENTISTRY PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 TWYCKENHAM BLVD
LAFAYETTE IN
47909-6760
US

IV. Provider business mailing address

821 TWYCKENHAM BLVD
LAFAYETTE IN
47909-6760
US

V. Phone/Fax

Practice location:
  • Phone: 765-477-0331
  • Fax:
Mailing address:
  • Phone: 765-477-0331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CASEY CASTLE
Title or Position: DIRECTOR OF PAYOR CONTRACTING AND S
Credential:
Phone: 912-732-1504