MEDICARE: DR. TODD ALAN FLEISCHMAN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	22DI02294500	NJ
2	1223G0001X	General Practice Dentistry	DS036087	PA

General Provider Information

NPI Number	:	1154400463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD ALAN FLEISCHMAN D.M.D.

Provider Business Mailing Address
First Line	:	1824 CHRISTIAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2647
Country	:	US
Telephone Number	:	215-370-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 WALNUT ST
Second Line	:	SUITE 1100
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5457
Country	:	US
Telephone Number	:	215-545-0400
Fax Number	:	215-545-6696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	08/12/2010

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