Provider Demographics
NPI:1205074879
Name:FRITCH, EDWARD KENT (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:KENT
Last Name:FRITCH
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18650 N THOMPSON PEAK PKWY
Mailing Address - Street 2:SUITE 2010
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6190
Mailing Address - Country:US
Mailing Address - Phone:602-689-0508
Mailing Address - Fax:
Practice Address - Street 1:18650 N THOMPSON PEAK PKWY
Practice Address - Street 2:SUITE 2010
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6190
Practice Address - Country:US
Practice Address - Phone:602-689-0508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ45161223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics