Individual
DR. JEFFREY PAUL FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
107 W MAIN ST, CROSBY, MN 56441-1423
(218) 546-6031
(218) 546-8159
Mailing address
107 W MAIN ST, CROSBY, MN 56441-1423
(218) 546-6031
(218) 546-8159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10663
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226222300
—
MN
Enumeration date
04/24/2006
Last updated
08/19/2014
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