Provider Demographics
NPI:1225132442
Name:FISCHER, HENRY ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:ANTHONY
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 U.S. HIGHWAY #1
Mailing Address - Street 2:PO BOX 780068
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32978
Mailing Address - Country:US
Mailing Address - Phone:772-589-5337
Mailing Address - Fax:772-589-5359
Practice Address - Street 1:10725 U.S. HIGHWAY #1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958
Practice Address - Country:US
Practice Address - Phone:772-589-5337
Practice Address - Fax:772-589-5359
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN3321122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist