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General NPI Number Information
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NPI Number | 1699624940
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Entity Type | Organization
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Legal Business Name | CASTROVILLE CHILDREN'S DENTAL ASSOCIATION PLLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1762 HWY 90 E SUITE #103
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City | CASTROVILLE
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State | TX
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Zip | 78009-2917
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Country | US
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Telephone | 830-346-1420
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Fax | 830-346-1421
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Provider Business Mailing Address
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Address Line | 1762 HWY 90 E SUITE #103
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City | CASTROVILLE
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State | TX
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Zip | 78009-2917
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Country | US
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Telephone | 830-346-1420
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Fax | 830-346-1421
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Authorized Official
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Title or Position | ANALYTICS MGR
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Name | MR. ROBERT C WEISMAN
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Credential |
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Telephone | 972-369-2226
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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 |
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License Number State |
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