Provider Demographics
NPI:1245432566
Name:FISHER, JEFFREY P (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
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 1:4400 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-7904
Mailing Address - Country:US
Mailing Address - Phone:916-390-3673
Mailing Address - Fax:
Practice Address - Street 1:4400 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-7904
Practice Address - Country:US
Practice Address - Phone:916-390-3673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46382122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist