Provider Demographics
NPI:1417269374
Name:FLESHNER, BRIAN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:G
Last Name:FLESHNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N PARK PL
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:IA
Mailing Address - Zip Code:50025-1239
Mailing Address - Country:US
Mailing Address - Phone:712-563-2659
Mailing Address - Fax:712-563-2659
Practice Address - Street 1:400 N PARK PL
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:IA
Practice Address - Zip Code:50025-1239
Practice Address - Country:US
Practice Address - Phone:712-563-2659
Practice Address - Fax:712-563-2659
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice