Organization
KOZAK ORTHODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYON R KOZAK DDS, MS (ORTHODONTIST)
(847) 603-1682
Entity
Organization
Contact information
Practice address
1326 MAIN ST, SUITE B, ANTIOCH, IL 60002-2181
(847) 603-1682
Mailing address
1326 MAIN ST, SUITE B, ANTIOCH, IL 60002-2181
(847) 603-1682
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19-025556
IL
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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