Healthcare Provider Details

I. General information

NPI: 1235352121
Provider Name (Legal Business Name): ALLEN L CASTEEL DENTURIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SMELTER AVE NE STE 3
GREAT FALLS MT
59404-1937
US

IV. Provider business mailing address

215 SMELTER AVE NE STE 3
GREAT FALLS MT
59404-1937
US

V. Phone/Fax

Practice location:
  • Phone: 406-216-4746
  • Fax: 406-216-4747
Mailing address:
  • Phone: 406-216-4746
  • Fax: 406-216-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License NumberMT DENTURIST 22
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: