Provider Demographics
NPI:1538256359
Name:FICHTER, MAURA A (DDS)
Entity type:Individual
Prefix:DR
First Name:MAURA
Middle Name:A
Last Name:FICHTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 MOORSBRIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-7419
Mailing Address - Country:US
Mailing Address - Phone:269-327-3400
Mailing Address - Fax:
Practice Address - Street 1:8150 MOORSBRIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-7419
Practice Address - Country:US
Practice Address - Phone:269-327-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0144011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice