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General NPI Number Information
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NPI Number | 1730248212
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Entity Type | Individual
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Provider Name | DENNIS CRAIG FITCH DDS
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 2240 EMILY, SUITE 150
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401
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Country | US
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Telephone | 760-943-1449
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Fax | 760-943-7674
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Provider Business Mailing Address
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Address Line | 2240 EMILY ST STE 150
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-5218
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Country | US
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Telephone | 805-541-3900
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Fax | 805-541-3900
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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 | 31915
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31915
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 31915
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License Number State | CA
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