Provider Demographics
NPI:1962405514
Name:FISHER, JAMES WALTER (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WALTER
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 1:1037 ROUTE 46
Mailing Address - Street 2:STE CG1
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2445
Mailing Address - Country:US
Mailing Address - Phone:973-473-4371
Mailing Address - Fax:973-473-2017
Practice Address - Street 1:1037 ROUTE 46
Practice Address - Street 2:STE CG1
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2445
Practice Address - Country:US
Practice Address - Phone:973-473-4371
Practice Address - Fax:973-473-2017
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ94951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice