Provider Demographics
NPI:1013172915
Name:MURDOCK, CASEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 E 600 N
Mailing Address - Street 2:
Mailing Address - City:FIRTH
Mailing Address - State:ID
Mailing Address - Zip Code:83236-1224
Mailing Address - Country:US
Mailing Address - Phone:208-346-6284
Mailing Address - Fax:
Practice Address - Street 1:926 MAIN ST
Practice Address - Street 2:SUITE # 14
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3359
Practice Address - Country:US
Practice Address - Phone:406-259-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2309122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist