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DR. SAMUEL L. CASTILLO DMD
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1235225228
Individual Registrant:DR. SAMUEL L. CASTILLO DMD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3418 HIGHWAY 17 TOCCOA, GA 30577-8865 US
Tel: 706-886-4256 Fax: 706-886-6439
Tel: 706-886-4256 Fax: 706-886-6439
Contact information for business:
PO BOX 279 EASTANOLLEE, GA 30538-0279 US
Tel: 706-886-4256 Fax: 706-886-6439
Tel: 706-886-4256 Fax: 706-886-6439
Registration Information:
NPI: 1235225228
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | GA | 10718 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
