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General NPI Number Information
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NPI Number | 1962400309
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Entity Type | Individual
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Provider Name | STANLEY PIZZITOLA DMD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 1888 MAIN ST
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City | HARTFORD
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State | CT
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Zip | 06120-2357
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Country | US
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Telephone | 860-768-9052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 143922
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City | ARECIBO
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State | PR
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Zip | 00614-3922
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Country | US
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Telephone | 939-630-0221
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Fax | 787-815-5172
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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 | 001751
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12402
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License Number State | CT
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