Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Kozacko DDS PA

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1114103066

Mark Kozacko DDS PA is an Oral and Maxillofacial Surgery (Dentist) in Raleigh, North Carolina. Registered with an NPI since 2008.

In the registry since
2008
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6817 Falls Of Neuse Rd Ste 101
Raleigh, NC 27615-5386
Phone: (919) 848-9871
Fax: (919) 848-7841
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1114103066
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Kozacko — President · (919) 848-9871
NPI enumeratedJanuary 10, 2008
Last updated in NPPESFebruary 25, 2008
Mailing address6817 Falls Of Neuse Rd, Suite 101, Raleigh, NC 27615-5386

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