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General NPI Number Information
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NPI Number | 1164668315
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Entity Type | Organization
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Legal Business Name | DONALD R FLEMING D.D.S. INC
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 7676 JACKSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92119-1500
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Country | US
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Telephone | 619-582-3600
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Fax | 619-582-9406
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Provider Business Mailing Address
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Address Line | 7676 JACKSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92119-1500
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Country | US
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Telephone | 619-582-3600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD ROBERT FLEMING
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Credential | D.D.S.
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Telephone | 619-582-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 22215CA
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License Number State | CA
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