Individual
MR. LEONARD M KOSTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
201 SOUTH FAIRFIELD STREET, LIGONIER, PA 15658
(724) 238-3066
(724) 238-2047
Mailing address
248 ROUTE 259, LIGONIER, PA 15658
(724) 238-3066
(724) 238-2047
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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