Provider Demographics
NPI:1518190487
Name:FISCHER, JOEL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
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 1:1 PARADIES LN
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-4031
Mailing Address - Country:US
Mailing Address - Phone:845-255-8350
Mailing Address - Fax:845-255-2620
Practice Address - Street 1:1 PARADIES LN
Practice Address - Street 2:SUITE 201A
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-4031
Practice Address - Country:US
Practice Address - Phone:845-255-8350
Practice Address - Fax:845-255-2620
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist