Organization
JCDC DENTAL INC
Active
Other names
Westchase Premier Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L CASTELLANO DMD (VICE PRESIDENT/DENTIST)
(813) 475-4528
Entity
Organization
Contact information
Practice address
12229 W LINEBAUGH AVE, TAMPA, FL 33626-1743
(813) 475-4528
(813) 475-4247
Mailing address
12229 W LINEBAUGH AVE, TAMPA, FL 33626-1743
(813) 475-4528
(813) 475-4247
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN15383
FLORIDA
FL
01
—
DN22073
FLORIDA
FL
01
—
DN9796
FLORIDA
FL
Enumeration date
02/15/2022
Last updated
02/15/2022
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