Provider Demographics
NPI:1013897560
Name:KOZLIK, MARSCIA MICHELLE (RDH)
Entity type:Individual
Prefix:
First Name:MARSCIA
Middle Name:MICHELLE
Last Name:KOZLIK
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18344 S FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-9382
Mailing Address - Country:US
Mailing Address - Phone:503-577-3322
Mailing Address - Fax:
Practice Address - Street 1:18344 S FERGUSON RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-9382
Practice Address - Country:US
Practice Address - Phone:503-577-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH8661124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist