Individual
CAITLYN MARIE LASTOVICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
210 W 38TH ST, SCOTTSBLUFF, NE 69361-4778
(308) 632-5131
Mailing address
210 W 38TH ST, SCOTTSBLUFF, NE 69361-4778
(308) 632-5131
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7230
NE
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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