MEDICARE: MICHAEL A. FLEMING D.D.S., P.C.

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	122300000X	Dentist

General Provider Information

NPI Number	:	1477867679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A. FLEMING D.D.S., P.C.

Provider Business Mailing Address
First Line	:	830 STATE ST
Second Line	:
City	:	BOYNE CITY
State	:	MI
Zip	:	49712-9179
Country	:	US
Telephone Number	:	231-582-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	830 STATE ST
Second Line	:
City	:	BOYNE CITY
State	:	MI
Zip	:	49712-9179
Country	:	US
Telephone Number	:	231-582-8000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL FLEMING
Credential	:
Telephone Number	:	231-582-8000

Provider Enumeration Date	:	07/29/2010
Last Update Date	:	07/29/2010

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