Organization
GLEN T. CASTO DDS,MDS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA POPPELL (MANAGER)
(772) 388-6400
Entity
Organization
Contact information
Practice address
621 SEBASTIAN BOULEVARD, SUITE B, SEBASTIAN, FL 32958
(772) 388-6400
(772) 388-6446
Mailing address
621 SEBASTIAN BLVD, SUITE B, SEBASTIAN, FL 32958-4309
(772) 388-6400
(772) 388-6446
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN16640
FL
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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