Organization
VIRGINIA CASTELO DMD.A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRIGNIA C CASTELO DMD (PRESIDENT)
(323) 666-3852
Entity
Organization
Contact information
Practice address
1321 N VERMONT AVE STE 4, LOS ANGELES, CA 90027-6307
(323) 666-3852
Mailing address
1321 N VERMONT AVE STE 4, LOS ANGELES, CA 90027-6307
(323) 666-3852
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
40554
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G 93846
—
CA
Enumeration date
09/16/2010
Last updated
09/16/2010
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