MEDICARE: ARTURO CASTELLANOS DENTAL GROUP CORPORATION

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

General Provider Information

NPI Number	:	1851912174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTURO CASTELLANOS DENTAL GROUP CORPORATION

Provider Business Mailing Address
First Line	:	4355 TWEEDY BLVD
Second Line	:
City	:	SOUTH GATE
State	:	CA
Zip	:	90280-6236
Country	:	US
Telephone Number	:	323-357-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4355 TWEEDY BLVD
Second Line	:
City	:	SOUTH GATE
State	:	CA
Zip	:	90280-6236
Country	:	US
Telephone Number	:	323-357-7900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARTURO CASTELLANOS
Credential	:	DDS
Telephone Number	:	562-234-7013

Provider Enumeration Date	:	04/27/2020
Last Update Date	:	04/27/2020

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