Individual
DR. DANIEL R. KOZICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4114 W 63RD ST, CHICAGO, IL 60629-5008
(773) 581-0811
(773) 581-1530
Mailing address
4114 W 63RD ST, CHICAGO, IL 60629-5008
(773) 581-0811
(773) 581-1530
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019 016502
IL
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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