Healthcare Provider Details

I. General information

NPI: 1134974579
Provider Name (Legal Business Name): BRYAN CASTILLO FIGUEROA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CARR. PUERTO RICO 2 STE 302
VEGA ALTA PR
00692-6901
US

IV. Provider business mailing address

URB. BUENA VISTA CALLE CALMA #1265
PONCE PR
00717
US

V. Phone/Fax

Practice location:
  • Phone: 787-883-6446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3558
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: