Provider Demographics
NPI:1811222482
Name:FLEISCHMANN, BROOKE LUNDY (DDS)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:LUNDY
Last Name:FLEISCHMANN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BROOKE
Other - Middle Name:HELEN
Other - Last Name:LUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1080 US HIGHWAY 287
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7004
Mailing Address - Country:US
Mailing Address - Phone:303-466-7300
Mailing Address - Fax:303-469-9595
Practice Address - Street 1:1080 US HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7004
Practice Address - Country:US
Practice Address - Phone:303-466-7300
Practice Address - Fax:303-469-9595
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice