Provider Demographics
NPI:1235352121
Name:CASTEEL, ALLEN L (DENTURIST)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:L
Last Name:CASTEEL
Suffix:
Gender:M
Credentials:DENTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SMELTER AVE NE STE 3
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1937
Mailing Address - Country:US
Mailing Address - Phone:406-216-4746
Mailing Address - Fax:406-216-4747
Practice Address - Street 1:215 SMELTER AVE NE STE 3
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1937
Practice Address - Country:US
Practice Address - Phone:406-216-4746
Practice Address - Fax:406-216-4747
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT DENTURIST 22122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000030314OtherBCBS
MT0150178Medicaid
MT5512471OtherCHIP