| Randolph R. Pitzer Dds Pc | |
|
2224 1st Ave W Williston ND 58801-6286 | |
| (701) 774-0259 | |
| (701) 774-0250 |
| Full Name | Randolph R. Pitzer Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 2224 1st Ave W, Williston, North Dakota |
| Authorized Official Name and Position | Randolph Richard Pitzer (OWNER PRES) |
| Authorized Official Contact | 7017740259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randolph R. Pitzer Dds Pc 2224 1st Ave W Williston ND 58801-6286 Ph: (701) 774-0259 | Randolph R. Pitzer Dds Pc 2224 1st Ave W Williston ND 58801-6286 Ph: (701) 774-0259 |
| NPI Number | 1154575199 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154575199 | NPI | - | NPPES |
| 40031 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1628 (North Dakota) | Primary |
| 122300000X | Dentist | 2010 (North Dakota) | Secondary |
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