Organization
SOUTHERN DE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PA
Active
Other names
Bruce D Fisher, MD, DMD, Bruce D Fisher MD DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE D FISHER MD, DMD (OWNER)
(302) 644-2977
Entity
Organization
Contact information
Practice address
17605 NASSAU COMMONS BLVD STE C, LEWES, DE 19958-6284
(302) 644-2977
(302) 645-7561
Mailing address
17605 NASSAU COMMONS BLVD STE C, LEWES, DE 19958-6284
(302) 644-2977
(302) 645-7561
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2000106563
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000015026
—
DE
Enumeration date
11/24/2006
Last updated
06/03/2022
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