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Individual

R. ANDREW KOKODYNSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
851 PARK DRIVE, SUITE 103, LAKE GENEVA, WI 53147-4586
(262) 248-8346
(262) 248-0130
Mailing address
851 PARK DR, SUITE 103, LAKE GENEVA, WI 53147-4586
(262) 248-8346
(262) 248-0130

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4764
IL

Other

Enumeration date
01/04/2007
Last updated
07/08/2007
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