Provider Demographics
NPI:1609993757
Name:CARLOS CASTRO-B., D.M.D.
Entity Type:Organization
Organization Name:CARLOS CASTRO-B., D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO-BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-277-9800
Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:SUITE 420
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7224
Mailing Address - Country:US
Mailing Address - Phone:617-277-9800
Mailing Address - Fax:617-277-5396
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE 420
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-277-9800
Practice Address - Fax:617-277-5396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179641223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty