Individual
GEORGE KOSTAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2626 TAMPA RD., SUITE 201, PALM HARBOR, FL 34684
(727) 787-7434
(727) 787-7173
Mailing address
1561 CANOPY OAKS BLVD., PALM HARBOR, FL 34683
(727) 786-8499
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN11104
FL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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