Provider Demographics
NPI:1356779466
Name:DR. DALE KASTING DENTISTRY, DMD, PC
Entity type:Organization
Organization Name:DR. DALE KASTING DENTISTRY, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KASTING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:918-245-5984
Mailing Address - Street 1:3905 S HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3829
Mailing Address - Country:US
Mailing Address - Phone:918-245-5984
Mailing Address - Fax:918-245-5989
Practice Address - Street 1:3905 S HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3829
Practice Address - Country:US
Practice Address - Phone:918-245-5984
Practice Address - Fax:918-245-5989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty