Provider Demographics
NPI:1609336478
Name:MIGUEL A CASTRO DDS, INC
Entity Type:Organization
Organization Name:MIGUEL A CASTRO DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-204-6062
Mailing Address - Street 1:81 GREGORY LANE
Mailing Address - Street 2:OFFICE 210
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4922
Mailing Address - Country:US
Mailing Address - Phone:925-204-6062
Mailing Address - Fax:925-240-8843
Practice Address - Street 1:81 GREGORY LANE
Practice Address - Street 2:OFFICE 210
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4922
Practice Address - Country:US
Practice Address - Phone:925-204-6062
Practice Address - Fax:925-240-8843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty