Provider Demographics
NPI:1508945858
Name:CASTLE DENTAL ASSOCIATES OF TEXAS PC
Entity Type:Organization
Organization Name:CASTLE DENTAL ASSOCIATES OF TEXAS PC
Other - Org Name:CASTLE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-836-7576
Mailing Address - Street 1:201 SANDPOINTE AVE
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-5778
Mailing Address - Country:US
Mailing Address - Phone:512-836-7576
Mailing Address - Fax:512-836-3181
Practice Address - Street 1:9025 RESEARCH BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7010
Practice Address - Country:US
Practice Address - Phone:512-836-7576
Practice Address - Fax:512-836-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty