Provider Demographics
NPI:1164547329
Name:KOSTEVA & MIHALAKIS, LLC
Entity Type:Organization
Organization Name:KOSTEVA & MIHALAKIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOSTEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-865-6999
Mailing Address - Street 1:2933 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-3233
Mailing Address - Country:US
Mailing Address - Phone:610-865-6999
Mailing Address - Fax:
Practice Address - Street 1:2933 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-3233
Practice Address - Country:US
Practice Address - Phone:610-865-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty