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General NPI Number Information
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NPI Number | 1558006619
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Entity Type | Organization
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Legal Business Name | FITE DENTISTRY, PLLC
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 1960 CAVE MILL RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-6337
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Country | US
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Telephone | 317-292-1911
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 SCOTTSVILLE RD STE B2 #130
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City | BOWLING GREEN
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State | KY
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Zip | 42104-5836
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Country | US
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Telephone | 317-292-1911
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | CHRISLYN LEE FITE
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Credential | DMD
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Telephone | 317-270-4478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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