Individual
DR. BENJAMIN COSTA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
114 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5775
(617) 495-1434
Mailing address
4142 ADAMS AVE, SAN DIEGO, CA 92116-2592
(619) 326-0157
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
64628
CA
122300000X
Dentist
Primary
DN1857166
MA
Other
Enumeration date
07/21/2015
Last updated
02/22/2021
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