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Individual
DR. TRENT WAYNE LISTELLO
Active
Individual
DR. TRENT WAYNE LISTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE00009050
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN.00202141
CO
Other
Enumeration date
12/18/2006
Last updated
03/14/2018
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