Individual
MR. CRAIG ALFRED COSTANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
48 NEWHALL ST, REVERE, MA 02151
(781) 284-2090
Mailing address
24 BATEMAN AVE, REVERE, MA 02151
(781) 284-2090
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17025
MA
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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