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Organization
CARL B. FITZSIMMONS, DDS, PA
Active
Organization
CARL B. FITZSIMMONS, DDS, PA
Active
Other names
Plymouth Station Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL BENTON FITZSIMMONS D.D.S. (PRESIDENT/CEO)
(763) 577-9840
Entity
Organization
Contact information
Practice address
16795 COUNTY ROAD 24, SUITE 6, PLYMOUTH, MN 55447-1201
(763) 577-9840
(763) 577-9843
Mailing address
16795 COUNTY ROAD 24, SUITE 6, PLYMOUTH, MN 55447-1201
(763) 577-9840
(763) 577-9843
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D11044
MN
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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