Individual
DR. BRYON RICHARD KOZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
10320 75TH ST, SUITE A, KENOSHA, WI 53142-7525
(262) 697-8766
(262) 697-5523
Mailing address
10320 75TH ST, SUITE A, KENOSHA, WI 53142-7525
(262) 697-8766
(262) 697-5523
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
19-025556
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5281-015
WI
Other
Enumeration date
03/29/2007
Last updated
02/24/2014
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