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NPI Code Detail

MEDICARE: RONALD H FLACHS D.D.S.

MEDICARE:   RONALD H FLACHS  D.D.S.
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
11223G0001XGeneral Practice Dentistry2901013452MI

General Provider Information

NPI Number : 1366579179
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD H FLACHS D.D.S.
Provider Business Mailing Address
First Line : 4855 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-4686
Country : US
Telephone Number : 269-375-0800
Fax Number :
Provider Business Practice Location Address
First Line : 4855 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-4686
Country : US
Telephone Number : 269-375-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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Directions to “ RONALD H FLACHS D.D.S.” Practice Location

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