Provider Demographics
NPI:1770606204
Name:PIZZINO, SALVATORE M (DDS)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:M
Last Name:PIZZINO
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 1:112 CAMBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7561
Mailing Address - Country:US
Mailing Address - Phone:203-537-8849
Mailing Address - Fax:
Practice Address - Street 1:5525 SPEEGLEVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-4070
Practice Address - Country:US
Practice Address - Phone:203-537-8849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT80931223G0001X
TX350421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice