Individual
DR. EDWARD DWIGHT KOSAKOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2515 COUNTRYSIDE BLVD STE A, CLEARWATER, FL 33763-1603
(727) 475-7519
Mailing address
12550 6TH STREET EAST, TREASURE ISLAND, FL 33706
(858) 837-1128
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
36125
CA
1223E0200X
Endodontics
DN10933
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330924971
TAX ID
CA
Enumeration date
03/07/2007
Last updated
07/21/2022
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