Provider Demographics
NPI:1558006619
Name:FITE DENTISTRY, PLLC
Entity Type:Organization
Organization Name:FITE DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISLYN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FITE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:317-270-4478
Mailing Address - Street 1:1945 SCOTTSVILLE RD STE B2
Mailing Address - Street 2:#130
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5836
Mailing Address - Country:US
Mailing Address - Phone:317-292-1911
Mailing Address - Fax:
Practice Address - Street 1:1960 CAVE MILL RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-6337
Practice Address - Country:US
Practice Address - Phone:317-292-1911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental