Provider Demographics
NPI:1265647614
Name:FLEISHER, NEIL ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ROBERT
Last Name:FLEISHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ROXBURY DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3202
Mailing Address - Country:US
Mailing Address - Phone:609-953-8408
Mailing Address - Fax:
Practice Address - Street 1:2417 S 9TH ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19148-3715
Practice Address - Country:US
Practice Address - Phone:215-462-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026576-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist