Organization
KOSTELIC & ASSOCIATES, PLLC
Active
Other names
Clemmons Village Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KOSTELIC DMD (OWNER/MANAGER)
(336) 577-1583
Entity
Organization
Contact information
Practice address
2265 LEWISVILLE CLEMMONS RD STE A, CLEMMONS, NC 27012-7459
(336) 577-1583
Mailing address
2265 LEWISVILLE CLEMMONS RD STE A, CLEMMONS, NC 27012-7459
(336) 577-1583
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2024
Last updated
03/05/2024
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