Individual
DR. STEPHEN MATTHEW CEOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5192
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5192
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13136
MN
390200000X
Student in an Organized Health Care Education/Training Program
1
—
Other
Enumeration date
02/28/2012
Last updated
12/04/2019
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