Organization
E. V. DECASTECKER DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESTELA V. DECASTECKER DDS (PRESIDENT)
(440) 975-9885
Entity
Organization
Contact information
Practice address
7320 INDUSTRIAL PARK BLVD, MENTOR, OH 44060-5318
(440) 975-9885
(440) 975-1634
Mailing address
7320 INDUSTRIAL PARK BLVD, MENTOR, OH 44060-5318
(440) 975-9885
(440) 975-1634
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30020652
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30020652
LICENCE
OH
05
—
3087887
—
OH
Enumeration date
04/23/2013
Last updated
04/23/2013
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