Healthcare Provider Details

I. General information

NPI: 1386618353
Provider Name (Legal Business Name): MICHAEL ANDREW FLEMING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 STATE ST
BOYNE CITY MI
49712-9179
US

IV. Provider business mailing address

830 STATE ST
BOYNE CITY MI
49712-9179
US

V. Phone/Fax

Practice location:
  • Phone: 231-582-8000
  • Fax: 231-582-6853
Mailing address:
  • Phone: 231-582-8000
  • Fax: 231-582-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18251
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: