Healthcare Provider Details

I. General information

NPI: 1053698985
Provider Name (Legal Business Name): DR NICK I FLEURY DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2011
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 NH ROUTE 104 STE A
MEREDITH NH
03253-5732
US

IV. Provider business mailing address

178 DANIEL WEBSTER HWY
MEREDITH NH
03253-5664
US

V. Phone/Fax

Practice location:
  • Phone: 603-515-4060
  • Fax: 603-782-0868
Mailing address:
  • Phone: 603-515-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3304
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS I FLEURY
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 603-515-4060