Provider Demographics
NPI:1588656565
Name:FANCHER, JAMES P (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:FANCHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BUIE LN
Mailing Address - Street 2:PO BOX 682
Mailing Address - City:MARTINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:78655-3868
Mailing Address - Country:US
Mailing Address - Phone:512-357-1503
Mailing Address - Fax:
Practice Address - Street 1:345 BUIE LN
Practice Address - Street 2:
Practice Address - City:MARTINDALE
Practice Address - State:TX
Practice Address - Zip Code:78655-3868
Practice Address - Country:US
Practice Address - Phone:512-357-1503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics