Basic Information
| Provider Information | |||||||||
| NPI: | 1649333097 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASTRO | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6901 HELEN OF TROY | ||||||||
| Address2: | BUILDING C | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155818070 | ||||||||
| FaxNumber: | 9152319400 | ||||||||
| Practice Location | |||||||||
| Address1: | 6901 HELEN OF TROY | ||||||||
| Address2: | BUILDING C | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155818070 | ||||||||
| FaxNumber: | 9152319400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 06/18/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 16172 | TX | Y | Dental Providers | Dentist |
No ID Information.