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General NPI Number Information
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NPI Number | 1154815165
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Entity Type | Organization
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Legal Business Name | GUILLERMO S, CASTILLO DDS DENTAL CORPORATION
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 18760 CRENSHAW BLVD
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City | TORRANCE
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State | CA
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Zip | 90504-5904
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Country | US
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Telephone | 310-324-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 18760 CRENSHAW BLVD
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City | TORRANCE
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State | CA
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Zip | 90504-5904
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Country | US
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Telephone | 310-324-9700
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MONICA MELLO
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Credential |
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Telephone | 909-240-4393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 50896
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License Number State | CA
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