Costello, Fredrick William

Costello, Fredrick William is an individual health care provider with primary practice located at 1089 W Granada Blvd Suite 1, Ormond Beach FL 32174-8116. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Costello, Fredrick William can be contacted via phone (386) 673-1611.

Contact Information

Primary practice address
1089 W Granada Blvd Suite 1 Ormond Beach FL 32174-8116
Phone: (386) 673-1611
Fax: (386) 672-3543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN6323 Florida

Profile Details

NPI number 1245243401
LBN Legal business name Costello, Fredrick William
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 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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