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Organization

RANDOLPH R. PITZER DDS PC

Active
Parent organization
RANDOLPH R. PITZER DDS PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RANDOLPH R. PITZER DDS PC
Authorized official
RANDOLPH RICHARD PITZER DDS (OWNER PRES)
(701) 774-0259
Entity
Organization

Contact information

Practice address
2224 1ST AVE W, WILLISTON, ND 58801-6286
(701) 774-0259
(701) 774-0250
Mailing address
2224 1ST AVE W, WILLISTON, ND 58801-6286
(701) 774-0259
(701) 774-0250

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1628
ND
122300000X
Dentist
2010
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40031
ND
Enumeration date
11/04/2008
Last updated
11/04/2008
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