Individual
DR. ALEXIS NICHOLE RENA'E FRITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1511 CHRISTY DR, JEFFERSON CITY, MO 65101-2854
(573) 632-2777
Mailing address
8575 STATE ROAD BB, NEW BLOOMFIELD, MO 65063-1335
(720) 345-9036
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
2023021408
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2023
Last updated
06/08/2023
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