Healthcare Provider Details

I. General information

NPI: 1275703308
Provider Name (Legal Business Name): CHRISTOPHER HEALY FLEMING D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 JESSE JEWELL PKWY NE STE B
GAINESVILLE GA
30501-2547
US

IV. Provider business mailing address

1660 JESSE JEWELL PKWY NE STE B
GAINESVILLE GA
30501-2547
US

V. Phone/Fax

Practice location:
  • Phone: 770-503-7333
  • Fax:
Mailing address:
  • Phone: 770-503-7333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN013909
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number5539
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: