Provider Demographics
NPI:1982088829
Name:CASTLE DENTAL GROUP PC
Entity Type:Organization
Organization Name:CASTLE DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-226-7654
Mailing Address - Street 1:4815 E CAREFREE HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-4717
Mailing Address - Country:US
Mailing Address - Phone:928-525-9263
Mailing Address - Fax:928-226-7331
Practice Address - Street 1:4815 E CAREFREE HWY
Practice Address - Street 2:STE 102
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-4717
Practice Address - Country:US
Practice Address - Phone:928-525-9263
Practice Address - Fax:928-226-7331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment