Provider Demographics
NPI:1750473898
Name:FISCHER, ROBERT GLENN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GLENN
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 1:595 OAK COMMONS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4211
Mailing Address - Country:US
Mailing Address - Phone:407-931-3733
Mailing Address - Fax:
Practice Address - Street 1:595 OAK COMMONS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4211
Practice Address - Country:US
Practice Address - Phone:407-931-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN142981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice