Provider Demographics
NPI:1457453003
Name:SCOTT B. PIZER, D.D.S., PLLC
Entity Type:Organization
Organization Name:SCOTT B. PIZER, D.D.S., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:PIZER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-753-1868
Mailing Address - Street 1:2250 S ONEIDA ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2559
Mailing Address - Country:US
Mailing Address - Phone:303-753-1868
Mailing Address - Fax:
Practice Address - Street 1:2250 S ONEIDA ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2559
Practice Address - Country:US
Practice Address - Phone:303-753-1868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00104029122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02040293Medicaid