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General NPI Number Information
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NPI Number | 1952389587
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Entity Type | Individual
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Provider Name | GERALD VINCENT NOWINSKI DDS
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4100 OKEMOS RD
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City | OKEMOS
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State | MI
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Zip | 48909-7916
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Country | US
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Telephone | 517-347-5138
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Fax |
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Provider Business Mailing Address
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Address Line | 1524 WOODSIDE DR
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City | EAST LANSING
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State | MI
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Zip | 48823
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Country | US
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Telephone | 517-347-5138
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10563
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License Number State | MI
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