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General NPI Number Information
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NPI Number | 1730288499
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Entity Type | Organization
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Legal Business Name | FISCHER FAMILY DENTISTRY, P.C.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 151 INDIAN LAKE BLVD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6204
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Country | US
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Telephone | 615-824-8870
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Fax | 615-826-0245
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Provider Business Mailing Address
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Address Line | 151 INDIAN LAKE BLVD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6204
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Country | US
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Telephone | 615-824-8870
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Fax | 615-826-0245
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KELLI FIELDS FISCHER
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Credential | D.M.D.
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Telephone | 615-824-8870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | TN5207
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License Number State | TN
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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 | TN 5234
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License Number State | TN
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