Provider Demographics
NPI:1457578270
Name:VAZQUEZ DEL CASTILLO, OSCAR DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:DAVID
Last Name:VAZQUEZ DEL CASTILLO
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 1:134 LANTANA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2948
Mailing Address - Country:US
Mailing Address - Phone:210-497-1034
Mailing Address - Fax:
Practice Address - Street 1:1583 COMMON ST STE 205
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3174
Practice Address - Country:US
Practice Address - Phone:830-625-2111
Practice Address - Fax:830-620-1373
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice