Organization
AMY-JO FISCHER DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY-JO PARDON DDS (PRESIDENT)
(336) 993-7645
Entity
Organization
Contact information
Practice address
406 W MOUNTAIN ST, KERNERSVILLE, NC 27284-2534
(336) 993-7645
Mailing address
406 W MOUNTAIN ST, KERNERSVILLE, NC 27284-2534
(336) 993-7645
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5538
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8998880
MEDICAID PROVIDER NUMBER
NC
01
—
98880
BCBS PROVIDER NUMBER
NC
Enumeration date
12/11/2006
Last updated
04/11/2016
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