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General NPI Number Information
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NPI Number | 1053307280
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Entity Type | Individual
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Provider Name | THOMAS JOHN PIZZOLO DDS
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Gender | Male
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 95 DUTCH HILL RD
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City | ORANGEBURG
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State | NY
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Zip | 10962-2159
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Country | US
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Telephone | 845-359-8424
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Fax |
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Provider Business Mailing Address
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Address Line | 200 OTTOWA LN
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City | FRANKLIN LAKES
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State | NJ
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Zip | 07417-2136
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 040553
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License Number State | NY
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