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NPI Code Detail

MEDICARE: STEVEN ANDREW COSGROVE DMD

MEDICARE: STEVEN ANDREW COSGROVE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist13347CT

General Provider Information

NPI Number : 1649853920
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN ANDREW COSGROVE DMD
Provider Business Mailing Address
First Line : 855 ANTHONY DR
Second Line :
City : ANTHONY
State : NM
Zip : 88021-9325
Country : US
Telephone Number : 575-882-3607
Fax Number :
Provider Business Practice Location Address
First Line : 855 ANTHONY DR
Second Line :
City : ANTHONY
State : NM
Zip : 88021-9325
Country : US
Telephone Number : 575-882-3607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2021
Last Update Date : 02/02/2026

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Directions to “ STEVEN ANDREW COSGROVE DMD” Practice Location

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