Provider Demographics
NPI:1083783948
Name:CASTEEL, GLENN EDWARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:EDWARD
Last Name:CASTEEL
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 1:11321 SPRINGFIELD PIKE
Mailing Address - Street 2:SPRINGWOOD PROFESSIONAL CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4201
Mailing Address - Country:US
Mailing Address - Phone:513-541-1941
Mailing Address - Fax:513-541-0773
Practice Address - Street 1:11321 SPRINGFIELD PIKE
Practice Address - Street 2:SPRINGWOOD PROFESSIONAL CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4201
Practice Address - Country:US
Practice Address - Phone:513-541-1941
Practice Address - Fax:513-541-0773
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH191421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice