Individual
DR. MARK ANTHONY FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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
122300000X
Dentist
Primary
DN010780
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277431
UNITED CONCORDIA CO INS
—
Enumeration date
10/02/2006
Last updated
07/08/2007
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