# J. DAVID FISHER, JR., DDS, PA

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

## Provider details

- **NPI number:** 1265457568
- **Authorized official:** J. DAVID FISHER JR. D.D.S. (DENTIST)
- **Authorized official phone:** (919) 776-0741

## Contact information

- **Practice address:** 1808 DOCTOR'S DR., SANFORD, NC 27330
- **Practice address phone:** (919) 776-0741
- **Practice address fax:** (919) 774-6443
- **Mailing address:** 1808 DOCTOR'S DR., SANFORD, NC 27330
- **Mailing address phone:** (919) 776-0741
- **Mailing address fax:** (919) 774-6443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3994 | NC | Yes |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 06/19/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 235997 | TRIGON ID \# | NC |
| 01 | — | 400044 | UNITED CONCORDIA | NC |
| 05 | — | 8992718 | — | NC |
| 01 | — | 92718 | BCBS ID \# | NC |