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General NPI Number Information
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NPI Number | 1992010482
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Entity Type | Organization
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Legal Business Name | KRISTEN H. FRITZ, D.D.S., M.S. & TODD S. BOVENIZER, D.D.S., M.S., P.A.
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 224 VILLAGE WALK DR
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-7681
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Country | US
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Telephone | 919-285-9981
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Fax | 919-285-9989
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Provider Business Mailing Address
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Address Line | 224 VILLAGE WALK DR
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-7681
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Country | US
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Telephone | 919-285-9981
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Fax | 919-285-9989
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTEN HURLEY FRITZ
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Credential | D.D.S., M.S.
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Telephone | 919-285-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 8434
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License Number State | NC
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