Provider Demographics
NPI:1699842666
Name:FISCHER, GEORGE ANDREW (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ANDREW
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 OAK ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-2444
Mailing Address - Country:US
Mailing Address - Phone:618-262-5564
Mailing Address - Fax:618-263-4187
Practice Address - Street 1:1114 OAK ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-2444
Practice Address - Country:US
Practice Address - Phone:618-262-5564
Practice Address - Fax:618-263-4187
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice