# LYLY FISHER DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174674915
- **Authorized official:** DR. LYLY FISHER DDS (OWNER, DENTIST)
- **Authorized official phone:** (425) 271-5705

## Contact information

- **Practice address:** 406 BURNETT AVE S, RENTON, WA 98057-2551
- **Practice address phone:** (425) 271-5705
- **Practice address fax:** (425) 271-0165
- **Mailing address:** 406 BURNETT AVE S, RENTON, WA 98057-2551
- **Mailing address phone:** (425) 271-5705
- **Mailing address fax:** (425) 271-0165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7067 | WA | Yes |

## Other

- **Enumeration date:** 01/16/2007
- **Last updated:** 08/22/2020