Individual
DR. DAVE JOHN LITZOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
545 E. JOHNSON ST, FOND DU LAC, WI 54935
(920) 924-9090
(920) 921-0800
Mailing address
545 E JOHNSON ST, FOND DU LAC, WI 54935
(920) 924-9090
(920) 921-0800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5000183-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33658400
—
WI
Enumeration date
06/27/2006
Last updated
05/08/2017
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