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Individual

PHILIP RAY FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, PLLC

Contact information

Practice address
103 HAYWOOD PARK DR, CLYDE, NC 28721-4405
(828) 627-1050
(828) 627-1056
Mailing address
124 GLENDALE DR, WAYNESVILLE, NC 28786-4736
(828) 452-3963

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5807
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0149121
BCBS
TN
01
615188
UNITED CONCORDIA
PA
01
7102NC
BCBS
MI
01
810-20124
BCBS
AL
05
8992724
NC
01
92724
BCBS
NC
Enumeration date
07/24/2006
Last updated
10/02/2013
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