Individual
DR. KEVIN JACOB NITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
850 SUMMIT AVE STOP 1, OCONOMOWOC, WI 53066-3920
(262) 567-0470
Mailing address
850 SUMMIT AVE STOP 1, OCONOMOWOC, WI 53066-3920
(262) 567-0470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001491-15
WI
Other
Enumeration date
05/13/2024
Last updated
11/25/2024
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