Individual
PAUL MICHAEL FORTUNATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S., ABGD
Contact information
Practice address
4102 PINION DR, 10 MEDICAL GROUUP, USAF ACADEMY, CO 80840-2502
(719) 333-5592
Mailing address
4102 PINION DR, 10 MEDICAL GROUUP, USAF ACADEMY, CO 80840-2502
(719) 333-5592
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6347
CT
Other
Enumeration date
01/25/2006
Last updated
07/07/2008
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