Provider Demographics
NPI:1417665464
Name:MARSHALL A FLEMING DMD PLLC
Entity Type:Organization
Organization Name:MARSHALL A FLEMING DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:336-909-3860
Mailing Address - Street 1:1020 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4144
Mailing Address - Country:US
Mailing Address - Phone:919-682-5327
Mailing Address - Fax:919-688-4588
Practice Address - Street 1:1220 RIVER DR APT 110
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3975
Practice Address - Country:US
Practice Address - Phone:336-909-3860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty