Provider Demographics
NPI:1790802973
Name:FUCHS & FUCHS DENTISTRY
Entity Type:Organization
Organization Name:FUCHS & FUCHS DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:P
Authorized Official - Last Name:EITENMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-225-6011
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-0829
Mailing Address - Country:US
Mailing Address - Phone:580-225-6011
Mailing Address - Fax:580-225-1766
Practice Address - Street 1:922 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-5212
Practice Address - Country:US
Practice Address - Phone:580-225-6011
Practice Address - Fax:580-225-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK45161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty