Organization
ROBERT VANCE COSTELLO, DDS, APDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA COSTELLO (OFFICE MANAGER)
(318) 368-9518
Entity
Organization
Contact information
Practice address
7699 HIGHWAY 2, FARMERVILLE, LA 71241-6165
(318) 368-9518
(318) 368-4480
Mailing address
7699 HIGHWAY 2, FARMERVILLE, LA 71241-6165
(318) 368-9518
(318) 368-4480
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5630
LA
Other
Enumeration date
09/15/2009
Last updated
09/15/2009
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