Organization
CASTANEDA FASSIOLI DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN ELIZABETH CASTANEDA FASSIOLI DDS (CEO)
(949) 716-7000
Entity
Organization
Contact information
Practice address
22706 ASPAN ST STE 602, LAKE FOREST, CA 92630-1603
(949) 716-7000
(949) 716-0600
Mailing address
22706 ASPAN ST STE 602, LAKE FOREST, CA 92630-1603
(949) 716-7000
(949) 716-0600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
101094
CA
Other
Enumeration date
12/07/2017
Last updated
02/11/2022
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