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NPI Code Detail

MEDICARE: DR. BROOKS K FISER, DDS PA

MEDICARE: DR. BROOKS K FISER, DDS PA
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1457957813
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. BROOKS K FISER, DDS PA
Provider Business Mailing Address
First Line : 9000 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5249
Country : US
Telephone Number : 479-459-3310
Fax Number :
Provider Business Practice Location Address
First Line : 9000 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5249
Country : US
Telephone Number : 479-459-3310
Fax Number :
Authorized Official
Title or Position : OWNER/OPERATOR
Name : DR. BROOKS K FISER
Credential : DDS
Telephone Number : 479-459-3310
Provider Enumeration Date : 12/09/2020
Last Update Date : 12/09/2020

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