Provider Demographics
NPI:1750418604
Name:PRITSKY, ALEXANDER (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:PRITSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7045 N CHESTNUT AVE
Mailing Address - Street 2:#102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0354
Mailing Address - Country:US
Mailing Address - Phone:559-298-3900
Mailing Address - Fax:559-298-3920
Practice Address - Street 1:7045 N CHESTNUT AVE
Practice Address - Street 2:#102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0354
Practice Address - Country:US
Practice Address - Phone:559-298-3900
Practice Address - Fax:559-298-3920
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics