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General NPI Number Information
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NPI Number | 1922116524
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Entity Type | Individual
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Provider Name | JOE CRAIG SCASTA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1550 COPPERFIELD PKWY STE 2
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City | COLLEGE STATION
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State | TX
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Zip | 77845-4674
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Country | US
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Telephone | 979-260-2626
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Fax | 979-260-2631
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Provider Business Mailing Address
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Address Line | 1550 COPPERFIELD PKWY STE 2
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City | COLLEGE STATION
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State | TX
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Zip | 77845-4674
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Country | US
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Telephone | 979-260-2626
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Fax | 979-260-2631
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20230
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License Number State | TX
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