Provider Demographics
NPI:1467502955
Name:FISHER, JAMES GERARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GERARD
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 1:20 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10928-2012
Mailing Address - Country:US
Mailing Address - Phone:845-446-3137
Mailing Address - Fax:
Practice Address - Street 1:US ARMY DENTAL ACTIVITY
Practice Address - Street 2:BLDG 606, 1ST FLOOR
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1905
Practice Address - Country:US
Practice Address - Phone:845-938-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048096-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist