Provider Demographics
NPI:1891722153
Name:MICHAEL F. FITZPATRICK, DMD
Entity Type:Organization
Organization Name:MICHAEL F. FITZPATRICK, DMD
Other - Org Name:FITZPATRICKDMD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/SENIOR DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-646-4822
Mailing Address - Street 1:22 MILL ST
Mailing Address - Street 2:SUITE 002
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-646-4822
Mailing Address - Fax:781-646-4873
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:SUITE 002
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-646-4822
Practice Address - Fax:781-646-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA168551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty