Provider Demographics
NPI:1578710083
Name:CASTILLO, EMMA E (DDS)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:E
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:ESTHER
Other - Last Name:SALAZAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4708 SANDPIPER AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2142
Mailing Address - Country:US
Mailing Address - Phone:956-467-8151
Mailing Address - Fax:
Practice Address - Street 1:ALDAMA 830
Practice Address - Street 2:ZONA CENTRO
Practice Address - City:REYNOSA
Practice Address - State:TAMAULIPAS
Practice Address - Zip Code:88500
Practice Address - Country:MX
Practice Address - Phone:899-922-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ29283001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice