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General NPI Number Information
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NPI Number | 1184764920
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Entity Type | Individual
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Provider Name | JOHN WILLIAM VITZ DDS
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1844 SAN MIGUEL DRIVE # 210
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City | WALNUT CREEK
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State | CA
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Zip | 94596-4913
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Country | US
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Telephone | 925-934-2350
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Fax | 925-934-2184
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Provider Business Mailing Address
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Address Line | 1365 MT PISGAH RD # 15
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City | WALNUT CREEK
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State | CA
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Zip | 94596
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Country | US
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Telephone | 925-944-5576
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D020797
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License Number State | CA
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