Provider Demographics
NPI:1689934812
Name:FISHER, CLAYTON ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:ARTHUR
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 1:3846 W DAVIS ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1975
Mailing Address - Country:US
Mailing Address - Phone:936-235-2024
Mailing Address - Fax:
Practice Address - Street 1:3846 W DAVIS ST STE 300
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1975
Practice Address - Country:US
Practice Address - Phone:936-235-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6895122300000X
MI2901020648122300000X
CA103202122300000X
TX369151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist