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General NPI Number Information
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NPI Number | 1528991270
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Entity Type | Organization
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Legal Business Name | JUSTIN KOSAR DMD LLC
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 60 METRIC DR
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City | TALLMADGE
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State | OH
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Zip | 44278-2337
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Country | US
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Telephone | 330-633-9510
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Fax |
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Provider Business Mailing Address
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Address Line | 60 METRIC DR
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City | TALLMADGE
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State | OH
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Zip | 44278-2337
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Country | US
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Telephone | 330-633-9510
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. JUSTIN KOSAR
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Credential | DMD
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Telephone | 330-633-9510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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