Provider Demographics
NPI:1306904974
Name:KOWALCZYK, MARGARET BARBARA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:BARBARA
Last Name:KOWALCZYK
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 WICKLOW RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-3196
Mailing Address - Country:US
Mailing Address - Phone:630-904-5012
Mailing Address - Fax:
Practice Address - Street 1:230 W MARTIN AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6536
Practice Address - Country:US
Practice Address - Phone:630-355-1780
Practice Address - Fax:630-355-7303
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics