Organization
GLEN T. CASTO DDS, MDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN CASTO (OWNER)
(772) 388-6400
Entity
Organization
Contact information
Practice address
621 SEBASTIAN BLVD, B, SEBASTIAN, FL 32958-4309
(772) 388-6400
Mailing address
621 SEBASTIAN BLVD, B, SEBASTIAN, FL 32958-4309
(772) 388-6400
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN16640
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN16978
FL
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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