Most Relevant Information
Provider Data
| NPI Number: | 1003825100 |
| Provider Name: | MICHAEL D COSGROVE DDS, PC |
| Entity Type: | Individual |
| Taxonomy Code: | 1223P0700X |
| Specialty: | Dentist |
| License Number: | 12556 |
Most Important Dates
| Enumeration Date: | 08/07/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1005 5TH AVE
FORT WORTH
TX
761042937
Practice Location Phone/Fax
| Phone: | 8173353555 |
| Fax: | 8173322955 |
Provider Mailing Location
1005 5TH AVE
FORT WORTH
TX
761042937
Provider Mailing Phone/Fax
| Phone: | 8173353555 |
| Fax: | 8173322955 |