# DR. LISA E FLETCHER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912094830
- **Gender:** F
- **Credential:** D.M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 11049 | FL | — |
| 1223G0001X | General Practice Dentistry | 11709 | TN | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 11/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11049 | LICENSE NUMBER | FL |
| 01 | — | 529529 | UNITED CONCORDIA INS CO | FL |
| 01 | — | 67946 | BLUE CROSS BLUE SHIELD FL | FL |