Provider Demographics
NPI:1851350060
Name:FLEMING, NICOLE ANNETTE (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ANNETTE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 GARDEN AVENUE
Mailing Address - Street 2:FORT SAM HOUSTON BUDGE DENTAL CLINIC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-808-3735
Mailing Address - Fax:
Practice Address - Street 1:3145 GARDEN AVENUE
Practice Address - Street 2:FORT SAM HOUSTON BUDGE DENTAL CLINIC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:210-808-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0507921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice