Individual
JACQUELINE SOHN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MDS
Contact information
Practice address
86 FORT COUCH RD, PITTSBURGH, PA 15241-1020
(412) 831-2080
Mailing address
86 FORT COUCH RD, PITTSBURGH, PA 15241-1020
(412) 831-2080
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS035264
PA
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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