Provider Demographics
NPI:1033122981
Name:CHARLES & KATHERINE FISCHER DDS PC
Entity Type:Organization
Organization Name:CHARLES & KATHERINE FISCHER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:BURAN
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-818-1500
Mailing Address - Street 1:5895 TRINITY PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120
Mailing Address - Country:US
Mailing Address - Phone:703-818-1500
Mailing Address - Fax:703-502-9580
Practice Address - Street 1:5895 TRINITY PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120
Practice Address - Country:US
Practice Address - Phone:703-818-1500
Practice Address - Fax:703-502-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010067801223G0001X
VA04010067841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty