Individual
KIMBERLEY M CASTILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1670 GARTH BROOKS BLVD, YUKON, OK 73099
(405) 494-3080
Mailing address
1670 GARTH BROOKS BLVD, YUKON, OK 73099
(405) 494-3080
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5752
LA
1223G0001X
General Practice Dentistry
Primary
7260
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1857521
—
LA
Enumeration date
11/25/2006
Last updated
12/19/2019
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