# ADRIAN ACOSTA DDS A PROF DENTAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADRIAN ACOSTA DDS A PROF DENTAL CORP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881163004
- **Legal business name:** ADRIAN ACOSTA DDS A PROF DENTAL CORP
- **Authorized official:** BRUNO BOVAL (TREASURER)
- **Authorized official phone:** (562) 552-1344

## Contact information

- **Practice address:** 901 W. WHITTIER BLVD, LA HABRA, CA 90631
- **Practice address phone:** (562) 905-8338
- **Mailing address:** 901 W. WHITTIER BLVD, LA HABRA, CA 90631
- **Mailing address phone:** (562) 905-8338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2018
- **Last updated:** 11/16/2018