Provider Demographics
NPI:1477629293
Name:FISCHER, GERHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERHARD
Middle Name:
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:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-0797
Mailing Address - Country:US
Mailing Address - Phone:918-322-5553
Mailing Address - Fax:918-322-5556
Practice Address - Street 1:464 E 141ST ST.
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033
Practice Address - Country:US
Practice Address - Phone:918-322-5553
Practice Address - Fax:918-322-5556
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK44641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice