Provider Demographics
NPI:1851368989
Name:RESTREPO-CASTANEDA, JORGE
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:RESTREPO-CASTANEDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USNH BOX 73
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09589-1000
Mailing Address - Country:CU
Mailing Address - Phone:01153-997-2241
Mailing Address - Fax:
Practice Address - Street 1:USNH BOX 73
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589-1000
Practice Address - Country:CU
Practice Address - Phone:01153-997-2241
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist