Healthcare Provider Details

I. General information

NPI: 1952376683
Provider Name (Legal Business Name): JOSEPH M FISCHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 G ST SUITE 3
BELLEVILLE KS
66935-2463
US

IV. Provider business mailing address

2337 G ST SUITE 3
BELLEVILLE KS
66935-2463
US

V. Phone/Fax

Practice location:
  • Phone: 785-527-5602
  • Fax: 785-527-5979
Mailing address:
  • Phone: 785-527-5602
  • Fax: 785-527-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6829
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: