Provider Demographics
NPI:1730288499
Name:FISCHER FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:FISCHER FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:FIELDS
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-824-8870
Mailing Address - Street 1:151 INDIAN LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6204
Mailing Address - Country:US
Mailing Address - Phone:615-824-8870
Mailing Address - Fax:615-826-0245
Practice Address - Street 1:151 INDIAN LAKE BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6204
Practice Address - Country:US
Practice Address - Phone:615-824-8870
Practice Address - Fax:615-826-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN52071223G0001X
TNTN 52341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty