Castillo Family Dentistry | |
1110 Walnut Dr Ardmore OK 73401-2353 | |
(580) 223-7779 | |
(580) 223-7789 |
Full Name | Castillo Family Dentistry |
---|---|
Speciality | Dentist |
Location | 1110 Walnut Dr, Ardmore, Oklahoma |
Authorized Official Name and Position | Eric R. Castillo (OWNER/PRESIDENT) |
Authorized Official Contact | 5802237779 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Castillo Family Dentistry 1110 Walnut Dr Ardmore OK 73401-2353 Ph: (580) 223-7779 | Castillo Family Dentistry 1110 Walnut Dr Ardmore OK 73401-2353 Ph: (580) 223-7779 |
NPI Number | 1245612936 |
---|---|
Provider Enumeration Date | 06/18/2015 |
Last Update Date | 06/18/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245612936 | NPI | - | NPPES |
200021060A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 5652 (Oklahoma) | Primary |
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