Individual
DR. KEITH DAVID NOWICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
32545 GARFIELD RD, FRASER, MI 48026-3843
(586) 293-3633
(586) 293-5683
Mailing address
32545 GARFIELD RD, FRASER, MI 48026-3843
(586) 293-3633
(586) 293-5683
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901017331
MI
1223G0001X
General Practice Dentistry
17331
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
973959
UNITED CONCORDIA MILITARY
MI
Enumeration date
03/24/2006
Last updated
06/08/2022
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