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Individual

DR. LUCAS R CASTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2436 S ACADEMY BLVD, COLORADO SPRINGS, CO 80916-2408
(719) 391-2336
(719) 391-1625
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
(719) 955-3470

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00202128
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
55975364
CO
01
DEN.00202128
CO OPTOMETRY LICENSE
CO
Enumeration date
07/08/2013
Last updated
06/12/2019
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