Provider Demographics
NPI:1952473316
Name:FISCHER, FRED FERENC (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:FERENC
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 1:25511 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1856
Mailing Address - Country:US
Mailing Address - Phone:248-443-2300
Mailing Address - Fax:248-443-0308
Practice Address - Street 1:25511 SOUTHFIELD RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1856
Practice Address - Country:US
Practice Address - Phone:248-443-2300
Practice Address - Fax:248-443-0308
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010118961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice