Organization
TREAVOR D FISHER, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREAVOR D FISHER DDS (DENTIST)
(541) 554-4734
Entity
Organization
Contact information
Practice address
470 HIGHLAND AVE, COOS BAY, OR 97420-2243
(541) 269-2100
Mailing address
470 HIGHLAND AVE, COOS BAY, OR 97420-2243
(541) 269-2100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9340
OR
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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