Individual
DR. JACKLYN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 E 89TH ST, APT 4J, NEW YORK, NY 10128-2318
(914) 629-3924
Mailing address
141 E 89TH ST, APT 4J, NEW YORK, NY 10128-2318
(914) 629-3924
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
056727
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/08/2011
Last updated
05/27/2015
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