Individual
DR. JACK COLEMAN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
8295 CORDOVA RD, SUITE 101, CORDOVA, TN 38016-2045
(901) 433-9181
(901) 433-9170
Mailing address
8295 CORDOVA RD, SUITE 101, CORDOVA, TN 38016-2045
(901) 433-9181
(901) 433-9170
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4275
TN
Other
Enumeration date
11/15/2006
Last updated
03/15/2012
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