Organization
CASTILLO ROMAN DENTAL INC
Active
Other names
Lakeview Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INGRID CAROLINA CASTILLO D.M.D. (OWNER)
(954) 752-7874
Entity
Organization
Contact information
Practice address
1390 CORAL RIDGE DR, CORAL SPRINGS, FL 33071-5434
(954) 752-7874
Mailing address
1390 CORAL RIDGE DR, CORAL SPRINGS, FL 33071-5434
(954) 752-7874
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 16293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN 16293
LICENSE NUMBER
FL
Enumeration date
05/20/2008
Last updated
05/20/2008
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