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Organization
ANTHONY DICOSTANZO DDS PC
Active
Organization
ANTHONY DICOSTANZO DDS PC
Active
Other names
Smiles By Doctor D
Organization subpart
No
Provider details
NPI number
Authorized official
MARTI BENNE (OFFICE MANANGER)
(219) 865-3303
Entity
Organization
Contact information
Practice address
1123 JOLIET ST, DYER, IN 46311-1926
(219) 865-3303
(219) 865-3244
Mailing address
1123 JOLIET ST, DYER, IN 46311-1926
(219) 865-3303
(219) 865-3244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007851A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100168120A
—
IN
Enumeration date
06/17/2015
Last updated
06/17/2015
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