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General NPI Number Information
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NPI Number | 1508945858
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Entity Type | Organization
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Legal Business Name | CASTLE DENTAL ASSOCIATES OF TEXAS PC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9025 RESEARCH BLVD SUITE 250
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City | AUSTIN
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State | TX
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Zip | 78758-7010
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Country | US
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Telephone | 512-836-7576
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Fax | 512-836-3181
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Provider Business Mailing Address
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Address Line | 201 SANDPOINTE AVE 8TH FLOOR
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City | SANTA ANA
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State | CA
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Zip | 92707-5778
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Country | US
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Telephone | 512-836-7576
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Fax | 512-836-3181
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROY D. SMITH
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Credential | DDS
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Telephone | 512-836-7576
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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 | 12072
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License Number State | TX
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