Provider Demographics
NPI:1902026321
Name:CASTELLON, PAULINO III (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULINO
Middle Name:
Last Name:CASTELLON
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAULINO
Other - Middle Name:
Other - Last Name:CASTELLON
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6029 BELT LINE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9196
Mailing Address - Country:US
Mailing Address - Phone:972-503-7200
Mailing Address - Fax:972-503-7276
Practice Address - Street 1:6029 BELT LINE RD STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254
Practice Address - Country:US
Practice Address - Phone:972-503-7200
Practice Address - Fax:972-503-7276
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57581223P0700X
TX249631223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics