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Individual
MR. LEONARD M KOSTLEY
Active
Individual
MR. LEONARD M KOSTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS023492L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101603728001
PA DEPT OF PUBLIC WELFARE
PA
01
—
K0436086
UNITED CONCORDIA
PA
Enumeration date
10/19/2006
Last updated
07/08/2007
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