Provider Demographics
NPI:1023506979
Name:FITCH, DONIELLE (RDH)
Entity type:Individual
Prefix:
First Name:DONIELLE
Middle Name:
Last Name:FITCH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:DONIELLE
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:888 WORCESTER ST STE 130
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-3744
Mailing Address - Country:US
Mailing Address - Phone:888-964-6681
Mailing Address - Fax:339-686-2561
Practice Address - Street 1:103 CARNEGIE CTR STE 300
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6235
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:888-662-0859
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22HI00750900124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist