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General NPI Number Information
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NPI Number | 1144306416
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Entity Type | Organization
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Legal Business Name | BENNY F FLEMING DDS PC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1501 BROOK AVE SUITE A
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5657
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Country | US
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Telephone | 940-723-0441
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Fax | 940-322-4374
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Provider Business Mailing Address
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Address Line | 1501 BROOK AVE SUITE A
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5657
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Country | US
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Telephone | 940-723-0441
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Fax | 940-322-4374
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENNY F FLEMING
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Credential | DDS
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Telephone | 940-723-0441
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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 | 8660
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License Number State | TX
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