Organization
FRYEBURG FAMILY DENTAL
Active
Other names
Bernadette Kozak
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERNADETTE KOZAK IPDH (OWNER/OPERATOR)
(207) 256-7606
Entity
Organization
Contact information
Practice address
19 PORTLAND ST, FRYEBURG, ME 04037-1205
(207) 256-7606
(207) 256-8086
Mailing address
PO BOX 523, 19 PORTLAND STREET, FRYEBURG, ME 04037-0523
(207) 256-7606
(207) 256-8086
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
IPH18
ME
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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