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1013151083
GLEN M CASTOR
NAMPA, ID
NPI
1013151083
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122400000X Denturist
(Licence: ID LD-53)
Enumeration Date
2009-04-21
Last Update Date
2009-04-21
Business Address
GLEN M CASTOR LD
306 12TH AVE S
NAMPA, ID 83651-4246
Phone number: 208-466-4205
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Mailing Address
GLEN M CASTOR LD
306 12TH AVE S
NAMPA, ID 83651-4246
Phone number: 208-466-4205
Copy
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