Provider Demographics
NPI:1053303776
Name:FISHER, WILLIAM F (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:FISHER
Suffix:
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 1:2323 W 2ND AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4652
Mailing Address - Country:US
Mailing Address - Phone:970-375-9006
Mailing Address - Fax:970-375-9044
Practice Address - Street 1:2323 W 2ND AVE
Practice Address - Street 2:SUITE E
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4652
Practice Address - Country:US
Practice Address - Phone:970-375-9006
Practice Address - Fax:970-375-9044
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0220207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist