Individual
KOSHY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
616 ROBIN RD, LAKELAND, FL 33803-4841
(863) 777-4442
Mailing address
6211 KNOB TREE DR, LITHIA, FL 33547-4922
(443) 676-8209
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
50056672
NY
122300000X
Dentist
Primary
DN24692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04319619
—
NY
Enumeration date
07/23/2013
Last updated
02/12/2020
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