Provider Demographics
NPI:1811603236
Name:FISCHER, CANDICE GALEGO (DMD)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:GALEGO
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1430
Mailing Address - Country:US
Mailing Address - Phone:561-614-9307
Mailing Address - Fax:
Practice Address - Street 1:1242 S FIFTH ST STE D
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9756
Practice Address - Country:US
Practice Address - Phone:919-304-1666
Practice Address - Fax:919-304-1698
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC131291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice