Provider Demographics
NPI:1053597286
Name:FRITZ, TIFFANY LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:LYNN
Last Name:FRITZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23761 E GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5811
Mailing Address - Country:US
Mailing Address - Phone:951-743-2893
Mailing Address - Fax:
Practice Address - Street 1:11246 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3202
Practice Address - Country:US
Practice Address - Phone:720-748-3100
Practice Address - Fax:720-748-0306
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO94641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice