Organization
LUIS CASTILLO PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE CASTILLO (SECRETARY)
(559) 221-0302
Entity
Organization
Contact information
Practice address
5359 N FRESNO ST STE 110F, FRESNO, CA 93710-6864
(559) 221-0302
(559) 221-0302
Mailing address
5359 N FRESNO ST STE 110F, FRESNO, CA 93710-6864
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
45659
CA
Other
Enumeration date
09/11/2017
Last updated
03/17/2018
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