Provider Demographics
NPI:1386958155
Name:CASTELLINI, MARCO P (DDS)
Entity type:Individual
Prefix:
First Name:MARCO
Middle Name:P
Last Name:CASTELLINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13205 REAMS ROAD
Mailing Address - Street 2:156
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786
Mailing Address - Country:US
Mailing Address - Phone:407-203-7037
Mailing Address - Fax:
Practice Address - Street 1:13205 REAMS ROAD
Practice Address - Street 2:156
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786
Practice Address - Country:US
Practice Address - Phone:407-203-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19870122300000X
MADL10946122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist