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General NPI Number Information
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NPI Number | 1396045845
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Entity Type | Organization
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Legal Business Name | TODD D. FLERE D.D.S. AND WILLIAM T. KUNKEL, JR., D.D.S., INC.
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 1041 E LIBERTY ST
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City | GIRARD
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State | OH
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Zip | 44420-2407
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Country | US
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Telephone | 330-759-8425
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Fax | 330-759-8425
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Provider Business Mailing Address
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Address Line | 1041 E LIBERTY ST P. O. BOX 430
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City | GIRARD
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State | OH
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Zip | 44420-2407
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Country | US
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Telephone | 330-759-8425
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Fax | 330-759-8425
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Authorized Official
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Title or Position | DENTIST
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Name | TODD D FLERE
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Credential | D.D.S.
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Telephone | 330-759-8425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21681
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15772
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License Number State | OH
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