Individual
MARK A COSTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
432 BUTTERFIELD RD, CHINO VALLEY, AZ 86323-5613
(928) 636-1565
(928) 636-1164
Mailing address
432 BUTTERFIELD RD, CHINO VALLEY, AZ 86323-5613
(928) 636-1565
(928) 636-1164
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6359
CA
1223G0001X
General Practice Dentistry
Primary
D5634
AZ
Other
Enumeration date
07/30/2007
Last updated
06/13/2016
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