Individual
ANDREA VITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 BENJAMIN H HILL DR SW, FITZGERALD, GA 31750-8694
(229) 423-9471
Mailing address
320 BENJAMIN H HILL DR SW, FITZGERALD, GA 31750-8694
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN016000
GA
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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