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General NPI Number Information
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NPI Number | 1861541484
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Entity Type | Individual
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Provider Name | MARC FISHER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13975 CONNECTICUT AVE STE 309
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City | SILVER SPRING
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State | MD
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Zip | 20906-2921
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Country | US
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Telephone | 301-871-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 306A CROSS GREEN ST
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5520
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Country | US
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Telephone |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 7011
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License Number State | MD
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