Individual
JUAN PABLO CASTRO CUELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 292-1472
Mailing address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 292-1472
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
71.000297
OH
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
71.000297
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0157098
—
OH
Enumeration date
03/24/2023
Last updated
11/24/2025
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