Individual
DR. MICHAEL J COSTA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
264 S PETERS RD, KNOXVILLE, TN 37923-5203
(865) 539-1776
(865) 539-1858
Mailing address
264 S PETERS RD, KNOXVILLE, TN 37923-5203
(865) 539-1776
(865) 539-1585
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10644
TN
122300000X
Dentist
9738
NC
Other
Enumeration date
06/17/2014
Last updated
05/23/2024
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