Provider Demographics
NPI:1760522999
Name:FISHER, DAVID MONROE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MONROE
Last Name:FISHER
Suffix:JR
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 1:3131 BATTLEGROUND AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2631
Mailing Address - Country:US
Mailing Address - Phone:336-288-1242
Mailing Address - Fax:336-288-2860
Practice Address - Street 1:3131 BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2631
Practice Address - Country:US
Practice Address - Phone:336-288-1242
Practice Address - Fax:336-288-2860
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice