Provider Demographics
NPI:1356339386
Name:FISHER, WILLIAM COURTNEY (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COURTNEY
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 1:1174 S 500 E
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-3700
Mailing Address - Country:US
Mailing Address - Phone:801-447-8555
Mailing Address - Fax:801-475-4797
Practice Address - Street 1:5974 FASHION POINT DR
Practice Address - Street 2:SUITE 210
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4699
Practice Address - Country:US
Practice Address - Phone:801-475-6121
Practice Address - Fax:801-475-4797
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD17451223G0001X
UT5955291-99231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice