Organization
MARK A FITZGERALD DMD PC
Active
Other names
Allatonna Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ANTHONY FITZGERALD DMD (PRESIDENT)
(770) 382-5678
Entity
Organization
Contact information
Practice address
100 COURTYARD DRIVE, CARTERSVILLE, GA 30120
(770) 382-5678
(770) 382-1108
Mailing address
100 COURTYARD DRIVE, CARTERSVILLE, GA 30120
(770) 382-5678
(770) 382-1108
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN010780
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277431
UNITED CONCORDIA CO INS
—
Enumeration date
08/31/2006
Last updated
08/22/2020
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