Individual
CASEY EDWARD TRAVELSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
940 US 31 W BYPASS, BOWLING GREEN, KY 42103
(270) 991-9138
Mailing address
940 US 31W BYP, BOWLING GREEN, KY 42101-2316
(270) 991-9138
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9614
KY
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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