Individual
COREY ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6611 KIRBY CENTER CV, MEMPHIS, TN 38115-4313
(901) 363-8192
Mailing address
717 S WHITE STATION RD STE 7, MEMPHIS, TN 38117-4538
(901) 692-1404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11562
TN
1223P0221X
Pediatric Dentistry
Primary
11562
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
TN
Other
Enumeration date
05/03/2021
Last updated
06/02/2023
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