Provider Demographics
NPI:1053366245
Name:FISCHER, WILLIAM A III (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:FISCHER
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3874 BURBANK RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691
Mailing Address - Country:US
Mailing Address - Phone:330-262-8383
Mailing Address - Fax:330-345-5223
Practice Address - Street 1:3874 BURBANK RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691
Practice Address - Country:US
Practice Address - Phone:330-262-8383
Practice Address - Fax:330-345-5223
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0198581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016171240001Medicaid
PA1016171240002Medicaid
PA1016171240007Medicaid
PA1016171240011Medicaid
PA1016171240003Medicaid
PA1016171240008Medicaid
PA1016171240012Medicaid
PA1016171240004Medicaid
PA1016171240005Medicaid
PA1016171240006Medicaid
PA1016171240009Medicaid
PA1016171240010Medicaid
PA1016171240013Medicaid