Provider Demographics
NPI:1396733606
Name:POZNICK, NANCY ANN (DDS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:POZNICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:UNIVERSITY OF DETROIT MERCY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-2576
Mailing Address - Country:US
Mailing Address - Phone:313-494-6700
Mailing Address - Fax:
Practice Address - Street 1:2700 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:UNIVERSITY OF DETROIT MERCY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208-2576
Practice Address - Country:US
Practice Address - Phone:313-494-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018487122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
381908328OtherGOLDEN DENTAL PLANS
381908328OtherDENTAL HEALTH ALLIANCE
88096MIOtherWADSWORTH
MI4473491Medicaid
88123MIOtherBAYSIDE
381908328OtherDENTEMAX
381908328OtherMETLIFE
88171MIOtherCOMMERCE
381908328020OtherDENTAL BLUE
381908328OtherGUARDIAN
88170MIOtherOUTER DRIVE
D801095OtherBLUE CROSS