Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22DI02605600 | NJ |
NPI | 1003299587 |
---|---|
Provider Name | Dr. Zachary Suval Spitzer |
First Address | Wayne, NJ 07470-7501 |
Second Address | Wayne, NJ 07470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2015 |
Last Update Date | 02/07/2015 |