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Contact Information

KEVIN D CASTLEBERRY, DDS
560 MILL ST
GREEN LAKE, WI54941
 Phone: 920-294-6790
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for KEVIN D CASTLEBERRY · (Male)

NPI Number 1366857146
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 06/30/2014
Last updated 05/16/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 7284-15
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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