MEDICARE: DR. FRANK A CASTILLO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	64613	CA

General Provider Information

NPI Number	:	1851775803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK A CASTILLO D.D.S.

Provider Business Mailing Address
First Line	:	3118 STORY RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-3815
Country	:	US
Telephone Number	:	408-254-8251
Fax Number	:	408-254-0687

Provider Business Practice Location Address
First Line	:	3118 STORY RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-3815
Country	:	US
Telephone Number	:	408-254-8251
Fax Number	:	408-254-0687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	07/18/2015

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