Provider Demographics
NPI:1831316033
Name:FRITZ, FREDERICK SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:SCOTT
Last Name:FRITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 SHADY GROVE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6228
Mailing Address - Country:US
Mailing Address - Phone:301-330-9550
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 201
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6228
Practice Address - Country:US
Practice Address - Phone:301-330-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12436174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist