Provider Demographics
NPI:1972657245
Name:FLEMING, JOHN WESLEY (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name:FLEMING
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1866 CANMONT DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3618
Mailing Address - Country:US
Mailing Address - Phone:404-661-8030
Mailing Address - Fax:
Practice Address - Street 1:10945 STATE BRIDGE RD
Practice Address - Street 2:SUITE 402
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8164
Practice Address - Country:US
Practice Address - Phone:770-569-0529
Practice Address - Fax:770-569-0377
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0134371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics