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NPI 1760517841

NPI 1760517841 : SCOTT EVAN ZITOFSKY DDS : CLIFTON PARK, NY

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General NPI Number Information
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    NPI Number           |    1760517841
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT EVAN ZITOFSKY DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/22/2007
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    Last Update Date     |    10/22/2009
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Provider Practice Location Address
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    Address Line         |    601 BRUNO RD 
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    City                 |    CLIFTON PARK
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    State                |    NY
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    Zip                  |    12065-1904
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    Country              |    US
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    Telephone            |    727-631-2456
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    601 BRUNO RD 
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    City                 |    CLIFTON PARK
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    State                |    NY
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    Zip                  |    12065-1904
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    Country              |    US
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    Telephone            |    727-631-2456
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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       |    22DI02303200
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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       |    D051800
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    License Number State |    NY
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