Provider Demographics
NPI:1194872929
Name:FIZER, JOHN ALVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALVIN
Last Name:FIZER
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 1:414 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-1712
Mailing Address - Country:US
Mailing Address - Phone:609-989-7088
Mailing Address - Fax:609-989-8884
Practice Address - Street 1:414 MARKET ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-1712
Practice Address - Country:US
Practice Address - Phone:609-989-7088
Practice Address - Fax:609-989-8884
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100929800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist