Provider Demographics
NPI:1104116649
Name:FISCHER, ANDREW GERARD (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GERARD
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 1:340 ROUTE 34 SOUTH
Mailing Address - Street 2:SUITE 204
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722
Mailing Address - Country:US
Mailing Address - Phone:732-431-6633
Mailing Address - Fax:732-431-6636
Practice Address - Street 1:340 ROUTE 34 SOUTH
Practice Address - Street 2:SUITE 204
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722
Practice Address - Country:US
Practice Address - Phone:732-431-6633
Practice Address - Fax:732-431-6636
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025034001223G0001X
NJ22DI025034011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice