Individual
DR. ELIZABETH SARA COSTA-CARROCCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
136 PHENIX AVE, CRANSTON, RI 02920-4259
(401) 942-4760
Mailing address
111 BEECHWOOD DR, CRANSTON, RI 02921-3315
(401) 942-4760
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN2278
RI
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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