Provider Demographics
NPI:1215530696
Name:MARGARET FITZSIMONS DDS, PC
Entity type:Organization
Organization Name:MARGARET FITZSIMONS DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:FITZSIMONS-HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-429-6931
Mailing Address - Street 1:5829 69TH LN
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2623
Mailing Address - Country:US
Mailing Address - Phone:718-429-6931
Mailing Address - Fax:
Practice Address - Street 1:5829 69TH LN
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2623
Practice Address - Country:US
Practice Address - Phone:718-429-6931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty