MR. Fredrick William Costello, D.D.S.
NPI #1245243401 in Ormond Beach, Florida
Provider Information
- NPI Number
- 1245243401
- Entity Type
- Individual
- Name
- MR. Fredrick William Costello, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S.
- Enumeration Date
- Aug 15, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1089 W GRANADA BLVD
- Address 2
- SUITE 1
- City
- Ormond Beach
- State
- Florida
- ZIP Code
- 32174-8116
- Phone
- (386) 673-1611
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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