Organization
EAU CLAIRE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN HENRY FLEMING DDS (VICE PRESIDENT)
(715) 832-8063
Entity
Organization
Contact information
Practice address
1018 REGIS CT, EAU CLAIRE, WI 54701-4404
(715) 832-8063
(715) 835-1231
Mailing address
1018 REGIS CT, EAU CLAIRE, WI 54701-4404
(715) 832-8063
(715) 835-1231
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2965
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245466317
NPI
—
01
—
1578657276
NPI
WI
01
—
1619063195
NPI
—
Enumeration date
11/13/2014
Last updated
11/13/2014
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