Individual
FADI N. KOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
501 W 14TH ST, WILMINGTON, DE 19801
(302) 428-6458
Mailing address
501 W 14TH ST, WILMINGTON, DE 19801-1013
(302) 428-4850
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
15840
MD
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
G1-0001385
DE
Other
Enumeration date
04/19/2012
Last updated
08/20/2018
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