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NPI Code Detail

MEDICARE: DR. JOHN WILLIAM VITZ DDS

MEDICARE:  DR. JOHN WILLIAM VITZ  DDS
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
1122300000XDentistD020797CA

General Provider Information

NPI Number : 1184764920
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN WILLIAM VITZ DDS
Provider Business Mailing Address
First Line : 1365 MT PISGAH RD
Second Line : # 15
City : WALNUT CREEK
State : CA
Zip : 94596
Country : US
Telephone Number : 925-944-5576
Fax Number :
Provider Business Practice Location Address
First Line : 1844 SAN MIGUEL DRIVE
Second Line : # 210
City : WALNUT CREEK
State : CA
Zip : 94596-4913
Country : US
Telephone Number : 925-934-2350
Fax Number : 925-934-2184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN WILLIAM VITZ DDS” Practice Location

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