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Individual

DR. KELLY BLISS KOSCSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
410 NE WALDO RD, GAINESVILLE, FL 32641-5685
(352) 375-3790
(352) 375-3791
Mailing address
410 NE WALDO RD, GAINESVILLE, FL 32641-5685
(352) 375-3790
(352) 375-3791

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18633
FL

Other

Enumeration date
06/03/2009
Last updated
01/11/2012
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