MEDICARE: DR. DAVID ANDREW NOFFERT D.D.S.

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	1223G0001X	General Practice Dentistry	14318	MI

General Provider Information

NPI Number	:	1932185899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ANDREW NOFFERT D.D.S.

Provider Business Mailing Address
First Line	:	2034 S ALMONT AVE
Second Line	:
City	:	IMLAY CITY
State	:	MI
Zip	:	48444-9732
Country	:	US
Telephone Number	:	810-724-3707
Fax Number	:	810-724-1299

Provider Business Practice Location Address
First Line	:	6800 NEWARK RD
Second Line	:	#300
City	:	IMLAY CITY
State	:	MI
Zip	:	48444
Country	:	US
Telephone Number	:	810-724-3707
Fax Number	:	810-724-1299

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	08/22/2022

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