Individual
GEORGIOS KOTSAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, PHD
Contact information
Practice address
110 BERGEN STREET, NEWARK, NJ 07103
(973) 972-4242
Mailing address
110 BERGEN STREET, D800, NEWARK, NJ 07103
(973) 972-7224
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
01644
NJ
1223P0300X
Periodontics
DF60582867
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1159275
—
NJ
Enumeration date
08/11/2015
Last updated
05/06/2026
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