NPI 1013151083

Glen M Castor, LD

Practitioner Denturist Nampa, ID

Practice location

Address: 306 12th Ave S, Nampa, ID 83651-4246
Phone: (208) 466-4205

Registered specialties

Denturist Primary

Dental Providers Taxonomy 122400000X Licence LD-53 (ID)

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Registry record

NPI: 1013151083
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Apr 2009
Record last updated: 21 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.