Individual
JULIE LYNN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1126 HARTFORD AVE, JOHNSTON, RI 02919-7109
(401) 519-1902
Mailing address
26 TAFT ST, COVENTRY, RI 02816-5313
(401) 440-0505
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DHO1527
RI
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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