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General NPI Number Information
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NPI Number | 1780932103
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Entity Type | Individual
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Provider Name | SUZANNE WARD FISCHARD DDS
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 720 MAIN ST SUITE 213
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City | MENDOTA HEIGHTS
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State | MN
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Zip | 55118-3757
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Country | US
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Telephone | 651-209-9219
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Fax |
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Provider Business Mailing Address
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Address Line | 951 SKYLINE LN SW
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City | ROCHESTER
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State | MN
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Zip | 55902-0985
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Country | US
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Telephone | 612-219-6816
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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 | D13158
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License Number State | MN
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