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NPI Code Detail

MEDICARE: DANIEL ROBERT FITZGERALD DMD

MEDICARE:   DANIEL ROBERT FITZGERALD  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN9500091MA

General Provider Information

NPI Number : 1821629247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL ROBERT FITZGERALD DMD
Provider Business Mailing Address
First Line : 11 GREENWOOD TER
Second Line :
City : SOMERVILLE
State : MA
Zip : 02143-3518
Country : US
Telephone Number : 860-682-5704
Fax Number :
Provider Business Practice Location Address
First Line : 19 BARNARD ST
Second Line :
City : ANDOVER
State : MA
Zip : 01810-3601
Country : US
Telephone Number : 978-475-5333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2020
Last Update Date : 03/05/2024

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Directions to “ DANIEL ROBERT FITZGERALD DMD” Practice Location

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