| NPI | 1619289246 |
|---|---|
| Professional Name | KELLIE D CASTRO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN015357) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8993) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2019-06-11 |