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General NPI Number Information
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NPI Number | 1326249616
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Entity Type | Organization
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Legal Business Name | ADRIAN J. COSTANZA
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 36 CONANT ST
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City | DANVERS
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State | MA
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Zip | 01923-2954
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Country | US
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Telephone | 978-774-8266
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Fax | 978-774-8293
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Provider Business Mailing Address
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Address Line | 36 CONANT ST
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City | DANVERS
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State | MA
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Zip | 01923-2954
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Country | US
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Telephone | 978-774-8266
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Fax | 978-774-8293
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. ADRIAN JOSEPH COSTANZA
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Credential | DENTIST
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Telephone | 19787748266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 8910
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License Number State | MA
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