Provider Demographics
NPI:1659791085
Name:JOHN M FISH DDS PA
Entity Type:Organization
Organization Name:JOHN M FISH DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-397-5514
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:HILDEBRAN
Mailing Address - State:NC
Mailing Address - Zip Code:28637-0665
Mailing Address - Country:US
Mailing Address - Phone:828-397-5514
Mailing Address - Fax:828-397-3980
Practice Address - Street 1:607 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:HILDEBRAN
Practice Address - State:NC
Practice Address - Zip Code:28637-8323
Practice Address - Country:US
Practice Address - Phone:828-397-5514
Practice Address - Fax:828-397-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5079332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1659555720OtherNPI