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NPI 1619362126

NPI 1619362126 : MR. DEVIN CHARLES CASTER : VANDENBERG AFB, CA

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General NPI Number Information
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    NPI Number           |    1619362126
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    Entity Type          |    Individual 
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    Provider Name        |    MR. DEVIN CHARLES CASTER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/01/2015
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    Last Update Date     |    04/06/2018
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Provider Practice Location Address
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    Address Line         |    338 S DAKOTA AVE 
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    City                 |    VANDENBERG AFB
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    State                |    CA
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    Zip                  |    93437-6307
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    Country              |    US
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    Telephone            |    805-606-1846
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    623 ARBOR ST 
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    City                 |    LOMPOC
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    State                |    CA
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    Zip                  |    93437-1303
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    Country              |    US
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    Telephone            |    949-291-9510
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    64590
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    License Number State |    CA
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