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Individual
MICHAEL L ICZKOVITZ
Active
Individual
MICHAEL L ICZKOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12008664
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2901011066
MI
Other
Enumeration date
07/19/2006
Last updated
04/28/2026
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