Individual
DUSTIN J. NOWOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18674
ND
Other
Enumeration date
06/23/2017
Last updated
08/16/2022
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