Individual
MATTHEW KOSTELIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2265 LEWISVILLE CLEMMONS RD STE A, CLEMMONS, NC 27012-7459
(336) 577-1583
Mailing address
2265 LEWISVILLE CLEMMONS RD STE A, CLEMMONS, NC 27012-7459
(336) 577-1583
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11043
NC
Other
Enumeration date
06/19/2018
Last updated
07/07/2021
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