Provider Demographics
NPI:1790918969
Name:CASTILLA, DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:CASTILLA
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 1:5100 BELMONT AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505
Mailing Address - Country:US
Mailing Address - Phone:330-759-1771
Mailing Address - Fax:330-759-1227
Practice Address - Street 1:5100 BELMONT AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44410
Practice Address - Country:US
Practice Address - Phone:330-759-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17975122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist