Organization
JEFFREY W. FISK, D.M.D, P.S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W FISK D.M.D (PRESIDENT)
(606) 451-1448
Entity
Organization
Contact information
Practice address
221 EAST SOMERSET CHURCH ROAD, SOMERSET, KY 42503
(606) 451-1448
(606) 451-8269
Mailing address
221 EAST SOMERSET CHURCH ROAD, SOMERSET, KY 42503
(606) 451-1448
(606) 451-8269
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7491
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60001179
—
KY
Enumeration date
10/03/2006
Last updated
08/22/2020
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