Provider Demographics
NPI:1336249929
Name:KASTROP, MARVIN C (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:C
Last Name:KASTROP
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 AVENUE E
Mailing Address - Street 2:SUITE B
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2999
Mailing Address - Country:US
Mailing Address - Phone:406-259-6774
Mailing Address - Fax:
Practice Address - Street 1:1701 AVENUE E
Practice Address - Street 2:SUITE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2999
Practice Address - Country:US
Practice Address - Phone:406-259-6774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics