Individual
MARK KOZLOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1000 W WALLINGS RD, SUITE D, BROADVIEW HTS, OH 44147-1200
(440) 546-9522
(440) 546-9564
Mailing address
1000 W WALLINGS RD, SUITE D, BROADVIEW HTS, OH 44147-1200
(440) 546-9522
(440) 546-9564
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30016184
OH
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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