Individual
KAI CODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6050 BRYNWOOD DR STE 102, ROCKFORD, IL 61114-6579
(815) 877-0694
Mailing address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 996-7460
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019033234
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021003452
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/20/2021
Last updated
07/22/2025
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