Provider Demographics
NPI:1558979260
Name:PRESTER, CASEY RAE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:RAE
Last Name:PRESTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:CASEY
Other - Middle Name:RAE
Other - Last Name:LEISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1829 S OHIO ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6601
Mailing Address - Country:US
Mailing Address - Phone:785-823-2472
Mailing Address - Fax:
Practice Address - Street 1:1829 S OHIO ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-6601
Practice Address - Country:US
Practice Address - Phone:785-823-2472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS616291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice