Jorge Enrique Mosquera Castrillon, DDS
Dentist in Springfield, IL. Individual provider (NPI-1).
NPI number1871190884
StatusActive
Last updated in NPPESJul 26, 2023
Details
- NPI
- 1871190884
- Entity type
- Individual (NPI-1)
- Name
- Jorge Enrique Mosquera Castrillon
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 2, 2020
- Certification date
- Jul 25, 2023
- Last updated
- Jul 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 019032932 | IL | Yes |
| 1223P0700X | Dentist, Prosthodontics | 021003081 | IL |
Practice location
687 E Linton AveSpringfield, IL 62703-5902
Phone 718-909-2550
Mailing address
3500 Sandpiper DrSpringfield, IL 62711-6722
Phone 561-635-8018
Other practice locations
1902 N Prospect Ave Ste 1
Champaign, IL 61822-1411
Champaign, IL 61822-1411
Phone 217-204-9025
2701 N Dirksen Pkwy
Springfield, IL 62702-1407
Springfield, IL 62702-1407
Phone 217-492-1400
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