Provider Demographics
NPI:1417648023
Name:BEN CASTELSKY DMD PLLC
Entity Type:Organization
Organization Name:BEN CASTELSKY DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:HARRIS BATES
Authorized Official - Last Name:CASTELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-996-9356
Mailing Address - Street 1:255 W MARTIN LUTHER KING BLVD UNIT 2703
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2052
Mailing Address - Country:US
Mailing Address - Phone:704-996-9356
Mailing Address - Fax:
Practice Address - Street 1:255 W MARTIN LUTHER KING BLVD UNIT 2703
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2052
Practice Address - Country:US
Practice Address - Phone:704-996-9356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental