Provider Demographics
NPI:1376797142
Name:CASTRO, MARJOORIE ETHEL (DDS)
Entity Type:Individual
Prefix:
First Name:MARJOORIE
Middle Name:ETHEL
Last Name:CASTRO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STERLING OAKS DR
Mailing Address - Street 2:227
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9451
Mailing Address - Country:US
Mailing Address - Phone:916-410-6008
Mailing Address - Fax:
Practice Address - Street 1:1010 MANGROVE AVE
Practice Address - Street 2:#A#B
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3551
Practice Address - Country:US
Practice Address - Phone:530-342-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist