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NPI Code Detail

MEDICARE: DR. MICHAEL FISHER D.D.S.

MEDICARE: DR. MICHAEL FISHER D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6564CO

General Provider Information

NPI Number : 1023321924
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL FISHER D.D.S.
Provider Business Mailing Address
First Line : 1400 GLENARM PL
Second Line :
City : DENVER
State : CO
Zip : 80202-5034
Country : US
Telephone Number : 303-534-2626
Fax Number : 303-892-7953
Provider Business Practice Location Address
First Line : 1400 GLENARM PL
Second Line : 200
City : DENVER
State : CO
Zip : 80202-5034
Country : US
Telephone Number : 303-534-2626
Fax Number : 303-892-7953
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2010
Last Update Date : 07/20/2010

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