| Victor J. Costanza | |
|
4655 Hoen Ave Santa Rosa CA 95405-7800 | |
| (707) 545-7575 | |
| (707) 545-7575 |
| Full Name | Victor J. Costanza |
|---|---|
| Speciality | Dentist |
| Location | 4655 Hoen Ave, Santa Rosa, California |
| Authorized Official Name and Position | Victor J Costanza (OWNER) |
| Authorized Official Contact | 7075457575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victor J. Costanza 4655 Hoen Ave Santa Rosa CA 95405-7800 Ph: (707) 545-7575 | Victor J. Costanza 4655 Hoen Ave Santa Rosa CA 95405-7800 Ph: (707) 545-7575 |
| NPI Number | 1073665949 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 06/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073665949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 39780 (California) | Primary |
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