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General NPI Number Information
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NPI Number | 1194023796
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Entity Type | Organization
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Legal Business Name | DELANEY ACOSTA, DMD, PLLC
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Dates
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Enumeration Date | 03/05/2011
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Last Update Date | 03/05/2011
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Provider Practice Location Address
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Address Line | 888 ROUTE 6
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City | MAHOPAC
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State | NY
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Zip | 10541-6201
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Country | US
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Telephone | 617-504-0163
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Fax |
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Provider Business Mailing Address
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Address Line | 888 ROUTE 6
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City | MAHOPAC
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State | NY
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Zip | 10541-6201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. DELANEY M ACOSTA
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Credential | DMD
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Telephone | 617-504-0163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 052975-1
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License Number State | NY
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