Provider Demographics
NPI:1790985844
Name:FITZGERALD, ALISON LEE (DDS)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:LEE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:LEE
Other - Last Name:HANOSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8245 N SILVERBELL RD STE 145
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7387
Mailing Address - Country:US
Mailing Address - Phone:520-881-8902
Mailing Address - Fax:
Practice Address - Street 1:8245 N SILVERBELL RD STE 145
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7387
Practice Address - Country:US
Practice Address - Phone:520-881-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO94351223G0001X
AZ86421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice