Individual
JOHN G. KOSTIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9205 BROADWAY, SUITE A, MERRILLVILLE, IN 46410
(219) 755-0123
(219) 756-1463
Mailing address
9205 BROADWAY, SUITE A, MERRILLVILLE, IN 46410
(219) 755-0123
(219) 756-1463
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009244
IN
Other
Enumeration date
05/16/2006
Last updated
07/08/2007
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