Provider Demographics
NPI:1447398268
Name:KASTING, DALE E (DMD)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:E
Last Name:KASTING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 STATE HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063
Mailing Address - Country:US
Mailing Address - Phone:918-245-5984
Mailing Address - Fax:918-245-5989
Practice Address - Street 1:3905 STATE HIGHWAY 97
Practice Address - Street 2:SUITE 100
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063
Practice Address - Country:US
Practice Address - Phone:918-245-5984
Practice Address - Fax:918-245-5989
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice