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General NPI Number Information
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NPI Number | 1972657245
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Entity Type | Individual
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Provider Name | JOHN WESLEY FLEMING DMD, MSD
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10945 STATE BRIDGE RD SUITE 402
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City | ALPHARETTA
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State | GA
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Zip | 30022-8164
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Country | US
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Telephone | 770-569-0529
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Fax | 770-569-0377
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Provider Business Mailing Address
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Address Line | 1866 CANMONT DR NE
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City | ATLANTA
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State | GA
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Zip | 30319-3618
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Country | US
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Telephone | 404-661-8030
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN013437
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License Number State | GA
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