Healthcare Provider Details

I. General information

NPI: 1700085107
Provider Name (Legal Business Name): HILARY LORRAINE FRITSCH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N 11TH AVE STE 3
BOZEMAN MT
59715-3264
US

IV. Provider business mailing address

108 N 11TH AVE STE 3
BOZEMAN MT
59715-3264
US

V. Phone/Fax

Practice location:
  • Phone: 406-325-7096
  • Fax: 406-300-0695
Mailing address:
  • Phone: 406-325-7096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number21399
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number21692
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number21399
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: