Organization
DENTAL SURGERY SPECIALISTS OF OKEECHOBEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN CASTO DDS,MDS (OWNER)
(863) 824-6125
Entity
Organization
Contact information
Practice address
113 NE 19TH DR, OKEECHOBEE, FL 34972-1933
(863) 824-6125
Mailing address
113 NE 19TH DR, OKEECHOBEE, FL 34972-1933
(863) 824-6125
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN16640
FL
1223P0300X
Periodontics
DN17032
FL
Other
Enumeration date
07/10/2012
Last updated
07/20/2012
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