| NPI | 1619221827 |
|---|---|
| Doing Business As | COSA/COSTELLO ORAL SURGERY ASSOCIATES, LLC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL COSTELLO Owner 201-712-5556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ DI19847) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ DI19847) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2015-09-15 |