Organization
ASHBECK ORTHODONTIC ASSOCIATES INC
Active
Organization
ASHBECK ORTHODONTIC ASSOCIATES INC
Active
Other names
North Shore Orthodontic Associates
Organization subpart
No
Provider details
NPI number
Authorized official
BRYON KOZAK DDS MS (PRESIDENT OWNER)
(847) 234-4400
Entity
Organization
Contact information
Practice address
225 E DEERPATH RD STE 280, LAKE FOREST, IL 60045-1973
(847) 234-4400
(847) 234-4403
Mailing address
225 E DEERPATH RD STE 280, LAKE FOREST, IL 60045-1973
(847) 234-4400
(847) 234-4403
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104946912
NPI
IL
01
—
1407925050
NPI
IL
01
—
1689743247
NPI
IL
Enumeration date
11/29/2006
Last updated
02/12/2008
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