Organization
COSMET ENTERPRIZE LLC
Active
Other names
The Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES P COSTELLO DDS (PRESIDENT)
(352) 408-1400
Entity
Organization
Contact information
Practice address
12344 ROPER BLVD, CLERMONT, FL 34771-4300
(352) 242-1763
(352) 242-6376
Mailing address
12344 ROPER BLVD, CLERMONT, FL 34771-4300
(352) 242-1763
(352) 242-6376
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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