Organization
LUCAS CASTILLO PC
Active
Parent organization
DENTAL CARE AT RED ROCK CANYON
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL CARE AT RED ROCK CANYON
Authorized official
DR. LUCAS RAMON CASTILLO DDS (DENTIST)
(901) 413-3685
Entity
Organization
Contact information
Practice address
3113 W COLORADO AVE, COLORADO SPRINGS, CO 80904-2040
(901) 413-3685
Mailing address
3113 W COLORADO AVE, COLORADO SPRINGS, CO 80904-2040
(901) 413-3685
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55975364
—
CO
Enumeration date
07/28/2019
Last updated
07/28/2019
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