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General NPI Number Information
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NPI Number | 1437204070
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Entity Type | Organization
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Legal Business Name | JEFFREY A. SULITZER, DMD, INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 1037 E PALMDALE BLVD SUITE 203
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City | PALMDALE
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State | CA
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Zip | 93550-4745
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Country | US
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Telephone | 661-272-9181
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Fax | 661-272-8932
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Provider Business Mailing Address
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Address Line | 1037 E PALMDALE BLVD SUITE 203
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City | PALMDALE
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State | CA
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Zip | 93550-4745
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Country | US
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Telephone | 661-272-9181
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Fax | 661-272-8932
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY A. SULITZER
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Credential | DMD
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Telephone | 661-272-9181
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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 | D51841
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License Number State | CA
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