Doctor Name: | DR. ROBERT S. FIEDLER |
NPI Number: | 1104860196 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DMD |
License Number: | 17511 |
Business Practice Address: | 199 New Rd Central Square Suite 32 Linwood, NJ - 082212025 |
Business Phone Number: | 6099279090 |
Business Fax Number: | 6099279091 |
Mailing Address: | 199 New Rd, Central Square Suite 32 LINWOOD |
State: | NJ |
Postal Code: | 082212025 |
Phone Number: | 6099279090 |
Fax Number: | 6099279091 |
NPI Enumeration Date: | 06/16/2006 |
NPI Last Update Date: | 07/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | 17511 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |