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General NPI Number Information
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NPI Number | 1255519625
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Entity Type | Organization
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Legal Business Name | MARK G. CASTOR
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 140 PRESTON EXECUTIVE DRIVE SUITE 200
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City | CARY
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State | NC
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Zip | 27513
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Country | US
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Telephone | 919-467-6111
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Fax | 919-380-0088
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Provider Business Mailing Address
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Address Line | 140 PRESTON EXECUTIVE DRIVE SUITE 200
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City | CARY
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State | NC
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Zip | 27513
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Country | US
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Telephone | 919-467-6111
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Fax | 919-380-0088
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHEILA HAWKINSON
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Credential |
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Telephone | 919-467-6111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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