Provider Demographics
NPI:1265814990
Name:FLESHER, ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:FLESHER
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 1:2717 BOSTWICK ST.
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5412
Mailing Address - Country:US
Mailing Address - Phone:847-721-3532
Mailing Address - Fax:
Practice Address - Street 1:1403 N LOOP 336 W STE C
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3672
Practice Address - Country:US
Practice Address - Phone:936-539-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-030178122300000X
TX31915122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist