Organization
ALEKSEY KOZLOV, D.M.D., LLC
Active
Other names
East Mountain Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEKSEY KOZLOV DMD (MEMBER)
(916) 247-2048
Entity
Organization
Contact information
Practice address
2 BIRCH ROAD, CEDAR CREST, NM 87008
(505) 281-2622
Mailing address
13150 WENONAH AVE SE APT 521, ALBUQUERQUE, NM 87123-3857
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124513288
NPI
NM
Enumeration date
01/04/2021
Last updated
01/04/2021
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