| Lucas Castillo Pc | |
|
3113 W Colorado Ave Colorado Springs CO 80904-2040 | |
| (901) 413-3685 | |
| Not Available |
| Full Name | Lucas Castillo Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3113 W Colorado Ave, Colorado Springs, Colorado |
| Authorized Official Name and Position | Lucas Ramon Castillo (DENTIST) |
| Authorized Official Contact | 9014133685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucas Castillo Pc 3113 W Colorado Ave Colorado Springs CO 80904-2040 Ph: (901) 413-3685 | Lucas Castillo Pc 3113 W Colorado Ave Colorado Springs CO 80904-2040 Ph: (901) 413-3685 |
| NPI Number | 1932753001 |
|---|---|
| Provider Enumeration Date | 07/28/2019 |
| Last Update Date | 07/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932753001 | NPI | - | NPPES |
| 55975364 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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