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General NPI Number Information
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NPI Number | 1215701016
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Entity Type | Individual
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Provider Name | KRISANE A CASTILLO RDH
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Gender | Female
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 19501 DOCTORS DR
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City | GERMANTOWN
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State | MD
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Zip | 20874-5247
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Country | US
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Telephone | 301-528-2600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 109
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City | SEVERNA PARK
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State | MD
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Zip | 21146-0109
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Country | US
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Telephone | 412-390-4970
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 8707
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License Number State | MD
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