Provider Demographics
NPI:1235231184
Name:FITZPATRICK, THOMAS ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREW
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2428
Mailing Address - Country:US
Mailing Address - Phone:858-755-9775
Mailing Address - Fax:
Practice Address - Street 1:625 VALLEY AVE
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2428
Practice Address - Country:US
Practice Address - Phone:858-755-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA547371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice