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General NPI Number Information
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NPI Number | 1619013810
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Entity Type | Organization
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Legal Business Name | DOMINIC A. CASTALDO
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 120 LAFAYETTE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3000
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Country | US
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Telephone | 610-444-5042
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Fax |
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Provider Business Mailing Address
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Address Line | 120 LAFAYETTE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3000
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Country | US
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Telephone | 610-444-5042
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DOMINIC A. CASTALDO
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Credential | DDS
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Telephone | 610-444-5042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS016128L
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License Number State | PA
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