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Individual

RICHARD KOZLOWSKI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1229 MAIN ST, ST JOHNSBURY, VT 05819-2697
(802) 748-3906
(802) 748-5456
Mailing address
1229 MAIN ST, ST JOHNSBURY, VT 05819-2697
(802) 748-3906
(802) 748-5456

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016-0001017
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1002004
VT
05
30008241
NH
Enumeration date
07/24/2006
Last updated
07/09/2007
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