Provider Demographics
NPI:1154530392
Name:RIZZI, ROBERT N (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:RIZZI
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 1:30 STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1915
Mailing Address - Country:US
Mailing Address - Phone:732-940-1991
Mailing Address - Fax:
Practice Address - Street 1:4095 ROUTE 1 SOUTH
Practice Address - Street 2:SUITE 30
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852
Practice Address - Country:US
Practice Address - Phone:732-329-8844
Practice Address - Fax:732-329-9209
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01730001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist