NPI 1831106541 · live from the CMS NPI Registry
Edmund J Costello, DMD
Dentist, Orthodontics and Dentofacial Orthopedics in West Roxbury, MA. National Provider Identifier 1831106541, active.
NPI record
| NPI | 1831106541 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 1698 Centre St, West Roxbury, MA 02132 |
| Practice phone | 617-327-9656 |
| Enumerated | August 2, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | MA10764 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.