Organization
MT. PROSPECT DENTAL EXCELLENCE, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E. COSTELLO D.D.S. (DENTIST/OWNER)
(847) 259-1111
Entity
Organization
Contact information
Practice address
1640 N. ARLINGTON HEIGHTS RD., SUITE 201, ARLINGTON HEIGHTS, IL 60004
(847) 259-1111
(847) 259-2222
Mailing address
1640 N. ARLINGTON HEIGHTS RD., SUITE 201, ARLINGTON HEIGHTS, IL 60004
(847) 259-1111
(847) 259-2222
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
19A12900
IL
Other
Enumeration date
01/15/2007
Last updated
09/09/2015
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