Organization
G R KOZINA, DDS & ASSOC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA FORMICOLA (PRACTICE MANAGER)
(847) 689-3800
Entity
Organization
Contact information
Practice address
2127 GREEN BAY RD, NORTH CHICAGO, IL 60064-2801
(847) 689-3800
(847) 689-0191
Mailing address
PO BOX 1404, NORTH CHICAGO, IL 60064-8404
(847) 689-3800
(847) 689-0191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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