MEDICARE: DR. DAVID E NOWICKI D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	22DI01097200	NJ

General Provider Information

NPI Number	:	1982788915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E NOWICKI D.M.D.

Provider Business Mailing Address
First Line	:	141 S EUCLID AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2129
Country	:	US
Telephone Number	:	908-233-9370
Fax Number	:	908-233-3711

Provider Business Practice Location Address
First Line	:	141 S EUCLID AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2129
Country	:	US
Telephone Number	:	908-233-9370
Fax Number	:	908-233-3711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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