Provider Demographics
NPI:1023044260
Name:POLITZ, JEFFREY (DDS)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:POLITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 VILLA LN
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3087
Mailing Address - Country:US
Mailing Address - Phone:707-255-5033
Mailing Address - Fax:707-255-1554
Practice Address - Street 1:3301 VILLA LN
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3087
Practice Address - Country:US
Practice Address - Phone:707-255-5033
Practice Address - Fax:707-255-1554
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA404851223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery