Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | AZ4516 | AZ |
NPI | 1205074879 |
---|---|
Provider Name | Dr. Edward Kent Fritch |
First Address | Scottsdale, AZ 85255-6190 |
Second Address | Scottsdale, AZ 85255-6190 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2009 |
Last Update Date | 22/04/2014 |