Provider Demographics
NPI:1942525357
Name:CONCORD MILLS FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:CONCORD MILLS FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-941-1157
Mailing Address - Street 1:6438 NOLENSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4605
Mailing Address - Country:US
Mailing Address - Phone:615-941-1157
Mailing Address - Fax:615-941-1158
Practice Address - Street 1:6438 NOLENSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013
Practice Address - Country:US
Practice Address - Phone:615-941-1157
Practice Address - Fax:615-941-1158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty