Provider Demographics
NPI:1588678080
Name:FIFE, DAVID CALLISTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CALLISTER
Last Name:FIFE
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 1:1975 VILLAGE CENTER CIRCLE
Mailing Address - Street 2:STE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134
Mailing Address - Country:US
Mailing Address - Phone:702-360-2122
Mailing Address - Fax:702-360-3963
Practice Address - Street 1:1975 VILLAGE CENTER CIRCLE
Practice Address - Street 2:STE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134
Practice Address - Country:US
Practice Address - Phone:702-360-2122
Practice Address - Fax:702-360-3963
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV57361223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics