Individual
BRANDON MICHAEL FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
625 W 57TH ST, APT 463, NEW YORK, NY 10019-2937
(702) 326-6745
Mailing address
625 W 57TH ST APT 463, NEW YORK, NY 10019-2622
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
DS041005
PA
Other
Enumeration date
03/30/2013
Last updated
04/25/2019
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