Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL L ICZKOVITZ, D.D.S.
ActiveMICHAEL L ICZKOVITZ, D.D.S. is a Oral & Maxillofacial Surgery healthcare provider located in FORT WAYNE, Indiana. NPI 1235159930 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · FORT WAYNE, IN
Registration Details
- NPI Number
- 1235159930
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 19, 2006 (20.045102457763 yrs)
- Last Updated
- Mar 26, 2009
- Licenses
-
12008664 (IN)2901011066 (MI)
Practice Information
- Address
-
3303 TRIER RDFORT WAYNE, IN, 468154768Browse IN providers · Browse ZIP 46815
- Phone
- 2604849990
- Fax
- 2604846573
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
Other Oral & Maxillofacial Surgery Providers in FORT WAYNE, IN
| Name | Credential | NPI |
|---|---|---|
| JOHN JACOB SHANK | DDS | 1154349439 |
| ROBERT E. BRAUN | D.D.S. | 1649290354 |
| DR. ROBERT L REIFEIS JR. | D.D.S. | 1437179140 |
| DR. DAVID G BOJRAB | DDS | 1487664512 |
| DR. JOHN E BUHLER JR | DDS | 1376553412 |
| DR. TIMOTHY J SHAMBAUGH | DDS | 1124038260 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.