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Organization
MARK FISHER DDS PROFESSIONAL DENTAL CORPORATION
Active
Organization
MARK FISHER DDS PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK FISHER D.D.S. (PRESIDENT)
(818) 345-2025
Entity
Organization
Contact information
Practice address
18411 VENTURA BLVD, TARZANA, CA 91356-4201
(818) 345-2025
(818) 345-3229
Mailing address
18411 VENTURA BLVD, TARZANA, CA 91356-4201
(818) 345-2025
(818) 345-3229
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
244475
DELTA DENTAL INSURANCE
CA
05
—
G9347801
—
CA
Enumeration date
05/22/2007
Last updated
07/10/2007
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