Provider Demographics
NPI:1700085107
Name:FRITSCH, HILARY LORRAINE (DMD)
Entity type:Individual
Prefix:DR
First Name:HILARY
Middle Name:LORRAINE
Last Name:FRITSCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N 11TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3264
Mailing Address - Country:US
Mailing Address - Phone:406-325-7096
Mailing Address - Fax:
Practice Address - Street 1:108 N 11TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3264
Practice Address - Country:US
Practice Address - Phone:406-325-7096
Practice Address - Fax:406-300-0695
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21692122300000X
MT21399332B00000X, 122300000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies