MEDICARE: PETER FRANCIS DAL PIZZOL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	043791	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174514483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER FRANCIS DAL PIZZOL DMD

Provider Business Mailing Address
First Line	:	1230 DUNCAN RD
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6405
Country	:	US
Telephone Number	:	201-224-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	1034 SAINT NICHOLAS AVE
Second Line	:	162 DENTAL PRACTICE
City	:	NEW YORK
State	:	NY
Zip	:	10032-5242
Country	:	US
Telephone Number	:	212-568-1222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	07/08/2007

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