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DR. LISA E FLETCHER DMD

>> Dentist >> Dental Providers

Registrant NPI Number: 1912094830

Individual Registrant:
DR. LISA E FLETCHER DMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1 ELEVENTH AVENUE SUITE D3 SHCLIMAR, FL 32579 US
Tel: 850-651-6700  Fax: 850-609-6796

Contact information for business:
1 ELEVENTH AVENUE SUITE D3 SHCLIMAR, FL 32579 US
Tel: 850-651-6700  Fax: 850-609-6796

Registration Information:
NPI: 1912094830
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
FL11049

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
LICENSE NUMBER11049FL01
BLUE CROSS BLUE SHIELD FL67946FL01
UNITED CONCORDIA INS CO529529FL01




HEALTH CARE JOBS FL - Page 1



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