Organization
DANIEL R. KOZICKI, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL R. KOZICKI DDS (PRESIDENT/DENTIST)
(773) 581-0811
Entity
Organization
Contact information
Practice address
4114 W 63RD ST, CHICAGO, IL 60629-5008
(773) 581-0811
(773) 581-1530
Mailing address
4114 W 63RD ST, CHICAGO, IL 60629-5008
(773) 581-0811
(773) 581-1530
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
11/02/2006
Last updated
01/29/2008
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