Provider Demographics
NPI:1891135968
Name:CASTELE, MATTHEW THEODORE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:THEODORE
Last Name:CASTELE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 DORCHESTER RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-6849
Mailing Address - Country:US
Mailing Address - Phone:864-249-0621
Mailing Address - Fax:412-937-9014
Practice Address - Street 1:4400 DORCHESTER RD
Practice Address - Street 2:SUITE 108
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-6849
Practice Address - Country:US
Practice Address - Phone:864-249-0621
Practice Address - Fax:412-937-9014
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039655122300000X
SC87481223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No122300000XDental ProvidersDentist