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General NPI Number Information
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NPI Number | 1437285954
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Entity Type | Individual
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Provider Name | MARY ELIZABETH FIEDLER DDS
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30131 TOWN CENTER DRIVE SUITE 138
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2010
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Country | US
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Telephone | 949-249-3473
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Fax | 949-249-3494
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Provider Business Mailing Address
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Address Line | 30131 TOWN CENTER DRIVE STE 138
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2010
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Country | US
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Telephone | 949-249-3473
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Fax | 949-249-3494
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36149
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License Number State | CA
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