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General NPI Number Information
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NPI Number | 1053551002
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Entity Type | Organization
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Legal Business Name | FITZGERALD DENTAL ASSOCIATES, PC
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 270 BUFFALO PLZ
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City | SARVER
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State | PA
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Zip | 16055-8302
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Country | US
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Telephone | 724-294-0011
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Fax | 724-294-2811
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Provider Business Mailing Address
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Address Line | 270 BUFFALO PLZ
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City | SARVER
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State | PA
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Zip | 16055-8302
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Country | US
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Telephone | 724-294-0011
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Fax | 724-294-2811
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Authorized Official
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Title or Position | DOCTOR/PRESIDENT
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Name | KIMBERLY ANN FITZGERALD
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Credential | DMD
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Telephone | 724-294-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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