Individual
JACK KOSZYKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
101 E CEDAR CREEK DR, CLEVELAND, OK 74020-9548
(918) 358-3512
Mailing address
7205 W 34TH ST, TULSA, OK 74107-4531
(918) 710-1876
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7873
OK
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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