Provider Demographics
NPI:1508477050
Name:RIZZO DENTISTRY PLLC
Entity Type:Organization
Organization Name:RIZZO DENTISTRY PLLC
Other - Org Name:MODERN DAY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:507-269-2774
Mailing Address - Street 1:11995 SINGLETREE LN STE 130
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5342
Mailing Address - Country:US
Mailing Address - Phone:952-257-7255
Mailing Address - Fax:
Practice Address - Street 1:11995 SINGLETREE LN STE 130
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-5342
Practice Address - Country:US
Practice Address - Phone:952-257-7255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty