Provider Demographics
NPI:1982726527
Name:FISCHER, KELLI F (DMD)
Entity Type:Individual
Prefix:DR
First Name:KELLI
Middle Name:F
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 1:151 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
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN52071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice