Provider Demographics
NPI:1679898274
Name:TASSOPOULOU-FISHELL, MARIA KONSTANTINOU (DMD, MDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:KONSTANTINOU
Last Name:TASSOPOULOU-FISHELL
Suffix:
Gender:F
Credentials:DMD, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2867 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3282
Mailing Address - Country:US
Mailing Address - Phone:724-941-9600
Mailing Address - Fax:724-941-7448
Practice Address - Street 1:620 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3968
Practice Address - Country:US
Practice Address - Phone:724-222-1063
Practice Address - Fax:724-222-2245
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0382081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics