Provider Demographics
NPI:1578617064
Name:FISHER, MARGARET E (RDHAP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:FISHER
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 HELENS LN
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2723
Mailing Address - Country:US
Mailing Address - Phone:415-640-2076
Mailing Address - Fax:
Practice Address - Street 1:30 VAN NESS AVE STE 210
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6082
Practice Address - Country:US
Practice Address - Phone:415-575-5719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP163124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist