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General NPI Number Information
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NPI Number | 1508271529
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Entity Type | Individual
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Provider Name | LAWRENCE ROBERT FISCHER JR. D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1971 N MAIN ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-7820
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Country | US
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Telephone | 843-371-5886
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Fax |
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Provider Business Mailing Address
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Address Line | 30 MEETING ST
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City | CHARLESTON
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State | SC
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Zip | 29401-2737
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Country | US
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Telephone | 843-300-8803
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Fax |
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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 | RES3450
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DGD.8514 GD
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License Number State | SC
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