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General NPI Number Information
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NPI Number | 1902302946
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Entity Type | Organization
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Legal Business Name | FISCHER FAMILY DENTISTRY LLC
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 2337 G ST STE 3
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City | BELLEVILLE
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State | KS
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Zip | 66935-2463
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Country | US
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Telephone | 785-527-5602
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Fax | 785-527-5979
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Provider Business Mailing Address
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Address Line | 2337 G ST STE 3
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City | BELLEVILLE
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State | KS
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Zip | 66935-2463
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Country | US
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Telephone | 785-527-5602
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Fax | 785-527-5979
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Authorized Official
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Title or Position | BKKP
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Name | MARY KOLSKY
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Credential |
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Telephone | 785-527-5602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 6829
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License Number State | KS
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