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General NPI Number Information
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NPI Number | 1023477304
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Entity Type | Organization
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Legal Business Name | J DANIEL FLEMING DDS PC
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Dates
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Enumeration Date | 02/16/2016
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 1819 WYANDOTTE ST
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City | KANSAS CITY
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State | MO
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Zip | 64108-1980
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Country | US
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Telephone | 816-841-0206
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Fax | 816-221-5503
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Provider Business Mailing Address
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Address Line | 1819 WYANDOTTE ST
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City | KANSAS CITY
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State | MO
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Zip | 64108-1980
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Country | US
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Telephone | 816-841-0206
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Fax | 816-221-5503
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Authorized Official
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Title or Position | OWNER
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Name | J DANIEL FLEMING
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Credential |
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Telephone | 816-841-0206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14474
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License Number State | MO
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