Provider Demographics
NPI:1790821569
Name:KENTON DENTAL CARE SALIBA FLEMING & HOLLAND LLC
Entity Type:Organization
Organization Name:KENTON DENTAL CARE SALIBA FLEMING & HOLLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-673-0706
Mailing Address - Street 1:121 NORTH DETROIT STREET
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326
Mailing Address - Country:US
Mailing Address - Phone:419-673-0706
Mailing Address - Fax:419-673-0725
Practice Address - Street 1:3674 NORTH HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-263-4040
Practice Address - Fax:614-267-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty