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Organization
THE CASTLEBERRY CENTER FOR AESTHETIC DENTISTRY
Active
Organization
THE CASTLEBERRY CENTER FOR AESTHETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRICK LAVONE CASTLEBERRY (DENTIST)
(713) 664-8000
Entity
Organization
Contact information
Practice address
138 VINTAGE PARK BLVD, SUITE #G, HOUSTON, TX 77070
(713) 320-9166
Mailing address
138 VINTAGE PARK BLVD, SUITE #G, HOUSTON, TX 77070
(713) 320-9166
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19513
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090849313
—
TX
Enumeration date
06/16/2008
Last updated
06/16/2008
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