Individual
THIAGO SANTOS COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9528 ANTIOCH RD, OVERLAND PARK, KS 66212-4058
(913) 286-5189
Mailing address
9259 W 121ST PL APT 121, OVERLAND PARK, KS 66213-2548
(919) 434-1908
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61647
KS
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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