Provider Demographics
NPI:1922116524
Name:SCASTA, JOE CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:CRAIG
Last Name:SCASTA
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 1:1550 COPPERFIELD PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4674
Mailing Address - Country:US
Mailing Address - Phone:979-260-2626
Mailing Address - Fax:979-260-2631
Practice Address - Street 1:1550 COPPERFIELD PKWY STE 2
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-4674
Practice Address - Country:US
Practice Address - Phone:979-260-2626
Practice Address - Fax:979-260-2631
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice