Fitzgerald, Josefina B
Fitzgerald, Josefina B is an individual health care provider with primary practice located at 2030 Lake Ave , Pueblo CO 81004-3536. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Fitzgerald, Josefina B can be contacted via phone (719) 543-8711.Contact Information
Primary practice address
2030 Lake Ave
Pueblo CO 81004-3536
Phone: (719) 543-8711
Fax: (719) 543-5340
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 6023 | Colorado |
Profile Details
| NPI number | 1174533285 |
|---|---|
| LBN Legal business name | Fitzgerald, Josefina B |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Feb 6th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174533285 | NPPES |
| Colorado | MEDICAID | 02602308 |
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