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Organization
WASHINGTON AVE DENTAL CENTER PC
Active
Organization
WASHINGTON AVE DENTAL CENTER PC
Active
Other names
Dentist on Washington
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JOHN COSTELLO III DMD (DENTIST/OWNER)
(215) 389-9889
Entity
Organization
Contact information
Practice address
544 WASHINGTON AVE, PHILA, PA 19147
(215) 389-9889
Mailing address
544 WASHINGTON AVE, PHILA, PA 19147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DSO36827
PA
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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