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General NPI Number Information
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NPI Number | 1164295267
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Entity Type | Individual
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Provider Name | ALINE ROGERIA FREIRE DE CASTILHO DDS, MSC, PHD
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Gender | Female
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 1121 W MICHIGAN ST # DS220
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5211
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Country | US
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Telephone | 463-273-7030
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Fax |
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Provider Business Mailing Address
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Address Line | 2183 SEASONS SOUTH DR UNIT 303
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City | CARMEL
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State | IN
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Zip | 46280-1655
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Country | US
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Telephone | 463-273-7030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | LDF230023
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License Number State | IN
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