Provider Demographics
NPI:1306382999
Name:GUILLERMO SALVADOR CASTILLO PROFESSIONAL DENTAL CORP
Entity type:Organization
Organization Name:GUILLERMO SALVADOR CASTILLO PROFESSIONAL DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:SALVADOR
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-927-1200
Mailing Address - Street 1:7359 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3606
Mailing Address - Country:US
Mailing Address - Phone:562-927-1200
Mailing Address - Fax:562-927-1220
Practice Address - Street 1:7359 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3606
Practice Address - Country:US
Practice Address - Phone:562-927-1200
Practice Address - Fax:562-927-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty