Individual provider · Type 1 NPI
Robert Vance Costello, DDS
Oral and Maxillofacial Surgery (Dentist) · Lafayette, LA
NPI number
1376565580
Active
Practice location
1911 W Congress St
Lafayette, LA 70506-4433
Fax (337) 233-6799
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | 5630 (LA) |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 5630 (LA) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
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About NPI 1376565580
Robert Vance Costello, DDS's National Provider Identifier is 1376565580, issued on Jul 24, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Lafayette, LA. The record was last updated on Nov 15, 2021.