Provider Demographics
NPI:1215152418
Name:FISHER, JANET LYNN (RDH)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:FISHER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:BLACKWELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:226 S PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-4502
Mailing Address - Country:US
Mailing Address - Phone:940-686-0575
Mailing Address - Fax:
Practice Address - Street 1:4800 TEXOMA PKWY STE 1018
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2092
Practice Address - Country:US
Practice Address - Phone:903-813-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12208124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist