Organization
KIZIOR & YOUNG ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W KIZIOR DDS.,MSD (PRESIDENT)
(812) 634-2040
Entity
Organization
Contact information
Practice address
2005 SAINT CHARLES ST, SUITE 3, JASPER, IN 47546-2270
(812) 634-2040
(812) 482-7405
Mailing address
2005 SAINT CHARLES ST, SUITE 3, JASPER, IN 47546-2270
(812) 634-2040
(812) 482-7405
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12010318A
IN
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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