Provider Demographics
NPI:1801018411
Name:DEL CASTILLO, LUIS (DMD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:DEL CASTILLO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CONANT RD APT 46
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1163
Mailing Address - Country:US
Mailing Address - Phone:781-369-1546
Mailing Address - Fax:
Practice Address - Street 1:392 COMMONWEALTH AVE
Practice Address - Street 2:MEZZANINE LEVEL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2801
Practice Address - Country:US
Practice Address - Phone:617-262-0156
Practice Address - Fax:617-424-6265
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18553051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics