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General NPI Number Information
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NPI Number | 1154400463
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Entity Type | Individual
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Provider Name | TODD ALAN FLEISCHMAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 1608 WALNUT ST SUITE 1100
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City | PHILADELPHIA
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State | PA
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Zip | 19103-5457
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Country | US
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Telephone | 215-545-0400
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Fax | 215-545-6696
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Provider Business Mailing Address
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Address Line | 1824 CHRISTIAN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2647
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Country | US
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Telephone | 215-370-0329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 22DI02294500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS036087
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License Number State | PA
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