Provider Demographics
NPI:1801015953
Name:FISCHER, DONALD T (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:T
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 1:124 N INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-1503
Mailing Address - Country:US
Mailing Address - Phone:317-831-3370
Mailing Address - Fax:317-834-1012
Practice Address - Street 1:124 N INDIANA ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1503
Practice Address - Country:US
Practice Address - Phone:317-831-3370
Practice Address - Fax:317-834-1012
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120085711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice