Healthcare Provider Details

I. General information

NPI: 1861677999
Provider Name (Legal Business Name): JOHN W FISCHER DDS MS ORTHODONTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 GLENMORE AVENUE SUITE 207
CINCINATTI OH
45238
US

IV. Provider business mailing address

3012 GLENMORE AVENUE SUITE 207
CINCINATTI OH
45238
US

V. Phone/Fax

Practice location:
  • Phone: 513-661-2222
  • Fax: 513-661-2222
Mailing address:
  • Phone: 513-661-2222
  • Fax: 513-661-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number12671
License Number StateOH

VIII. Authorized Official

Name: DR. JOHN WESLEY FISCHER
Title or Position: PRESIDENT
Credential: DDS MS
Phone: 513-661-2222