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General NPI Number Information
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NPI Number | 1619327830
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Entity Type | Individual
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Provider Name | PATRICK FITZGERALD D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2016
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 1441 FOREST HILL BLVD STE 300
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6095
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Country | US
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Telephone | 561-586-7502
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Fax |
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Provider Business Mailing Address
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Address Line | 1185 SW 9TH RD APT 102
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City | GAINESVILLE
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State | FL
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Zip | 32601-8280
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN 21871
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21871
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License Number State | FL
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