Provider Demographics
NPI:1154433837
Name:ACOSTA, FRANK ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANTHONY
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9275 SW 152ND ST STE 206
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1774
Mailing Address - Country:US
Mailing Address - Phone:305-233-3922
Mailing Address - Fax:305-233-2130
Practice Address - Street 1:9275 SW 152ND ST STE 206
Practice Address - Street 2:
Practice Address - City:VILLAGE OF PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1774
Practice Address - Country:US
Practice Address - Phone:305-233-3922
Practice Address - Fax:305-233-2130
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14715122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist