Provider Demographics
NPI:1194861807
Name:MARK E. FISCHER, D.M.D., P.A.
Entity Type:Organization
Organization Name:MARK E. FISCHER, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-846-7977
Mailing Address - Street 1:500 ROUTE 1
Mailing Address - Street 2:SUITE 1
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-4711
Mailing Address - Country:US
Mailing Address - Phone:207-846-7977
Mailing Address - Fax:207-846-7976
Practice Address - Street 1:500 ROUTE 1
Practice Address - Street 2:SUITE 1
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-4711
Practice Address - Country:US
Practice Address - Phone:207-846-7977
Practice Address - Fax:207-846-7976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty