Individual
DR. MICHAEL TED KOSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6632 W 10TH ST STE 101, GREELEY, CO 80634-9734
(970) 353-4848
Mailing address
6632 W 10TH ST STE 101, GREELEY, CO 80634-9734
(970) 353-4848
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10757
CO
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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