Healthcare Provider Details

I. General information

NPI: 1578617064
Provider Name (Legal Business Name): MARGARET E. FISHER R.D.H.A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 VAN NESS AVE STE 210
SAN FRANCISCO CA
94102-6082
US

IV. Provider business mailing address

70 HELENS LN
MILL VALLEY CA
94941-2723
US

V. Phone/Fax

Practice location:
  • Phone: 415-575-5719
  • Fax:
Mailing address:
  • Phone: 415-640-2076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberHAP163
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: