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DR. MICHAEL J FIDLER DDS

Oral and Maxillofacial Pathology

Binghamton, New York

Provider NPI: 1568468130

Provider Information:
DR. MICHAEL J FIDLER DDS
Gender: M


Practice Location:
161 RIVERSIDE DR STE 201 BINGHAMTON, NY 13905 US
Tel: 607-798-7169  Fax: 607-798-9204

Business Mailing Address:
161 RIVERSIDE DR STE 201 BINGHAMTON, NY 13905 US
Tel: 607-798-7169  Fax: 607-798-9204

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0106XDental Providers
Dentist
Oral and Maxillofacial Pathology
NY030712

Other Provider Identifiers:

IssuerNumberStateType
00554912NY05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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