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General NPI Number Information
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NPI Number | 1144368994
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Entity Type | Organization
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Legal Business Name | ANTHONY M PALLOTTA DDS PA
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 164 WARBURTON AVENUE
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City | HAWTHORNE
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State | NJ
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Zip | 07506
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Country | US
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Telephone | 973-427-4201
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Fax | 973-427-3480
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Provider Business Mailing Address
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Address Line | 164 WARBURTON AVENUE
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City | HAWTHORNE
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State | NJ
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Zip | 07506
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Country | US
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Telephone | 973-427-4201
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Fax | 973-427-3480
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ADAM M. RAUZMAN
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Credential | DDS
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Telephone | 973-427-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D102250101
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D100828600
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License Number State | NJ
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