Organization
MYSTIC WESTERLY ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY TODD KOZLOWSKI DDS (PRESIDENT)
(860) 442-4421
Entity
Organization
Contact information
Practice address
117 COW HILL RD, MYSTIC, CT 06355-1449
(860) 536-9661
Mailing address
117 COW HILL RD, MYSTIC, CT 06355-1449
(860) 536-9661
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8376
CT
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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