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General NPI Number Information
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NPI Number | 1285917161
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Entity Type | Organization
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Legal Business Name | CASTELLANO & CARPENTER DENTAL ASOCIATES, PC
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 7002 MCPHERSON RD STE 104
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City | LAREDO
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State | TX
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Zip | 78041-6442
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Country | US
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Telephone | 956-725-5035
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Fax |
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Provider Business Mailing Address
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Address Line | 7002 MCPHERSON RD STE 104
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City | LAREDO
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State | TX
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Zip | 78041-6442
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Country | US
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Telephone | 956-725-5035
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH B CASTELLANO
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Credential | DDS
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Telephone | 956-725-5035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16408
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 16249
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License Number State | TX
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