Provider Demographics
NPI:1134396310
Name:TODD A PIZZI DDS,LLC
Entity type:Organization
Organization Name:TODD A PIZZI DDS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-842-8838
Mailing Address - Street 1:307 GRAFTON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-6236
Mailing Address - Country:US
Mailing Address - Phone:508-842-8838
Mailing Address - Fax:508-842-6356
Practice Address - Street 1:307 GRAFTON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-6236
Practice Address - Country:US
Practice Address - Phone:508-842-8838
Practice Address - Fax:508-842-6356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19967122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty