Provider Demographics
NPI:1093584674
Name:CASTILE DENTAL GROUP PLLC
Entity Type:Organization
Organization Name:CASTILE DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:COREY
Authorized Official - Last Name:CASTILE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-992-9222
Mailing Address - Street 1:8152 25 MILE RD STE C
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-1904
Mailing Address - Country:US
Mailing Address - Phone:586-992-9222
Mailing Address - Fax:
Practice Address - Street 1:8152 25 MILE RD STE C
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-1904
Practice Address - Country:US
Practice Address - Phone:586-992-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental