Acosta, John A

Acosta, John A is an individual health care provider with primary practice located at 7734 Airways Blvd , Southaven MS 38671-5306. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Acosta, John A can be contacted via phone (662) 349-3838.

Contact Information

Primary practice address
7734 Airways Blvd Southaven MS 38671-5306
Fax: (662) 349-5923
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 3118 Mississippi
Dental Providers / Pediatric Dentistry 1223P0221X 7024 Tennessee

Profile Details

NPI number 1841356169
LBN Legal business name Acosta, John A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841356169 NPPES
Tennessee Other 3153834 BCBS TN PROVIDER
Tennessee MEDICAID 8088 BCBS TN PROVIDER

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