Fitzgerald, Paul Martin

Fitzgerald, Paul Martin is an individual health care provider with primary practice located at 1351 Main St , Brockton MA 02301. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Fitzgerald, Paul Martin can be contacted via phone (508) 587-2000.

Contact Information

Primary practice address
1351 Main St Brockton MA 02301
Fax: (508) 580-3552
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 10545 Massachusetts

Profile Details

NPI number 1275588956
LBN Legal business name Fitzgerald, Paul Martin
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated May 4th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275588956 NPPES
Massachusetts MEDICAID 0222321

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