Provider Demographics
NPI:1790073195
Name:CASTOR, CHRISTOPHER BRANDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRANDON
Last Name:CASTOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 E CONE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4534
Mailing Address - Country:US
Mailing Address - Phone:336-621-4927
Mailing Address - Fax:336-621-5376
Practice Address - Street 1:1430 E CONE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4534
Practice Address - Country:US
Practice Address - Phone:336-621-4927
Practice Address - Fax:336-621-5376
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice