Provider Demographics
NPI:1528058534
Name:FISHER, BRYAN PATRICK (DMD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:PATRICK
Last Name:FISHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3241
Mailing Address - Country:US
Mailing Address - Phone:412-922-3066
Mailing Address - Fax:412-922-3305
Practice Address - Street 1:993 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3241
Practice Address - Country:US
Practice Address - Phone:412-922-3066
Practice Address - Fax:412-922-3305
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030461L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice