Individual
DR. KEIFER LAYNE FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
318 W BROADWAY ST, SPIRO, OK 74959-2422
(918) 962-2466
(918) 962-4004
Mailing address
318 W BROADWAY ST, SPIRO, OK 74959-2422
(918) 962-2466
(918) 962-4004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4826
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100670270A
—
OK
01
—
4826
OKLAHOMA DENTAL LICENSE
OK
Enumeration date
09/21/2005
Last updated
09/12/2013
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