| Rafael Acosta, DDS, PC | |
|
110 Baughmans Ln Suite 140 Frederick MD 21702-4059 | |
| (240) 215-1138 | |
| (240) 215-1140 |
| Full Name | Rafael Acosta, DDS, PC |
|---|---|
| Speciality | Dentist |
| Location | 110 Baughmans Ln, Frederick, Maryland |
| Authorized Official Name and Position | Rafael A. Acosta (SOLE PROPRIETOR) |
| Authorized Official Contact | 2402151138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rafael Acosta, DDS, PC Po Box 1149 Frederick MD 21702-0149 Ph: (240) 215-1138 | Rafael Acosta, DDS, PC 110 Baughmans Ln Suite 140 Frederick MD 21702-4059 Ph: (240) 215-1138 |
| NPI Number | 1962783910 |
|---|---|
| Provider Enumeration Date | 09/05/2011 |
| Last Update Date | 09/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962783910 | NPI | - | NPPES |
| 12408 | Other | MD | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12408 (Maryland) | Primary |
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