Healthcare Provider Details

I. General information

NPI: 1477336915
Provider Name (Legal Business Name): AUGUSTUS WILLIAM FISCHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 08/17/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 E COLLEGE ST
PULASKI TN
38478-4315
US

IV. Provider business mailing address

5727 HEIRLOOM DR
MURFREESBORO TN
37129-0681
US

V. Phone/Fax

Practice location:
  • Phone: 931-363-1388
  • Fax:
Mailing address:
  • Phone: 615-691-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12313
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: