Provider Demographics
NPI:1396192167
Name:CASTERA, ANNE CHRISTINE STEPHIE (DMD)
Entity Type:Individual
Prefix:
First Name:ANNE CHRISTINE
Middle Name:STEPHIE
Last Name:CASTERA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18900 SW 106TH AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7701
Mailing Address - Country:US
Mailing Address - Phone:786-633-0330
Mailing Address - Fax:786-633-0331
Practice Address - Street 1:18900 SW 106TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-7701
Practice Address - Country:US
Practice Address - Phone:786-633-0330
Practice Address - Fax:786-633-0331
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN230481223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty