Provider Demographics
NPI:1871859496
Name:FISHER DENTURE & DENTAL CARE
Entity Type:Organization
Organization Name:FISHER DENTURE & DENTAL CARE
Other - Org Name:DENTURES TODAY II LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-903-3929
Mailing Address - Street 1:4404 W. WALNUT
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756
Mailing Address - Country:US
Mailing Address - Phone:479-246-0007
Mailing Address - Fax:479-246-0702
Practice Address - Street 1:4404 W. WALNUT
Practice Address - Street 2:SUITE 2
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756
Practice Address - Country:US
Practice Address - Phone:479-246-0007
Practice Address - Fax:479-246-0702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FISHER DENTURE & DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-09
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty