Individual
MR. NICKY WAYNE NANNFELDT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1600 NILES AVE, SAINT JOSEPH, MI 49085-1609
(269) 983-1812
(269) 983-3282
Mailing address
1600 NILES AVE, SAINT JOSEPH, MI 49085-1609
(269) 983-1812
(269) 983-3282
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10461
MI
Other
Enumeration date
06/11/2006
Last updated
07/08/2007
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