Parker Theodore Kastelic I, DMD

NPI #1104494632 in Trinidad, Colorado

Provider Information

NPI Number: 1104494632
Entity Type: Individual
Name: Parker Theodore Kastelic I, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Jun 11, 2021
Last Updated: Jun 11, 2021

Practice Location

Address: 2124 FREEDOM RD
City: Trinidad
State: Colorado
ZIP Code: 81082-1210
Phone: (719) 422-5696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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