Provider Demographics
NPI:1598931990
Name:FISHEL, DANIEL LLOYD WILLIAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LLOYD WILLIAM
Last Name:FISHEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 CAPE HORN RD
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-9071
Mailing Address - Country:US
Mailing Address - Phone:717-417-6263
Mailing Address - Fax:
Practice Address - Street 1:3125 CAPE HORN RD
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-9071
Practice Address - Country:US
Practice Address - Phone:717-417-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0361441223P0300X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223P0300XDental ProvidersDentistPeriodontics