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1972097251
MATTHEW KOSTELIC
CLEMMONS, NC
NPI
1972097251
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: NC 11043)
Enumeration Date
2018-06-19
Last Update Date
2021-07-07
Business Address
MATTHEW KOSTELIC DMD
2265 LEWISVILLE CLEMMONS RD STE A
CLEMMONS, NC 27012-7459
Phone number: 336-577-1583
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Mailing Address
MATTHEW KOSTELIC DMD
2265 LEWISVILLE CLEMMONS RD STE A
CLEMMONS, NC 27012-7459
Phone number: 336-577-1583
Copy
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