Individual
DR. TRENT WAYNE LISTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4102 PINION DR, 10 MDG, USAF ACADEMY, CO 80840-2502
(719) 333-5076
Mailing address
4102 PINION DR, 10 MDG, USAF ACADEMY, CO 80840-2502
(719) 333-5076
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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