Paul Thomas Fisher, D.D.S.
Individual provider Active NPI General Practice Dentistry · Berne, IN
NPI 1629322425 · NPPES record last updated Oct 31, 2012
Key facts
- NPI
- 1629322425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12011844A (IN)
- Practice address
- 220 Forest Park Dr
Berne, IN 46711-1740 - Phone
- (260) 589-2309
- NPI assigned
- Oct 31, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011844A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fisher Dental, P.C. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12011844A | IN | Yes |
Addresses
Primary practice location
220 Forest Park Dr
Berne, IN 46711-1740
Mailing address
220 Forest Park Dr
Berne, IN 46711-1740
Phone (260) 589-2309
Other providers in Berne, IN
- Family Hospice of Northeast Indiana Inc
- Leslie Ann Fickert
- Debra Ann Fiechter
- Fisher Dental, P.C.
- Edward A. Fisher
- Katie Fralick
- Diane Freygang
- Bailey Frick
- Grace Midwifery
- Dana Hackman
All providers in Berne, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.