# ADRIAN ACOSTA DDS A PROFESSIONAL DENTAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADRIAN ACOSTA DDS A PROFESSIONAL DE
- **Other names:** Gold Coast Dental Irvine Specialty Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003548173
- **Legal business name:** ADRIAN ACOSTA DDS A PROFESSIONAL DE
- **Authorized official:** ALAN BOVAL (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (562) 356-0948

## Contact information

- **Practice address:** 113 WATERWORKS WAY, 355, IRVINE, CA 92618-1367
- **Practice address phone:** (562) 356-0948
- **Practice address fax:** (866) 817-3581
- **Mailing address:** 901 W. WHITTIER BLVD, LA HABRA, CA 90631-3743
- **Mailing address phone:** (562) 356-0948
- **Mailing address fax:** (866) 817-3581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2022
- **Last updated:** 06/28/2022