| Kevin L Fleming, Dds A Professional Corporation | |
|
828 S Fairmont Ave Lodi CA 95240-5117 | |
| (209) 369-8218 | |
| (209) 368-2102 |
| Full Name | Kevin L Fleming, Dds A Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 828 S Fairmont Ave, Lodi, California |
| Authorized Official Name and Position | Kevin L Fleming (PRESIDENT) |
| Authorized Official Contact | 2093698218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin L Fleming, Dds A Professional Corporation 828 S Fairmont Ave Lodi CA 95240-5117 Ph: (209) 369-8218 | Kevin L Fleming, Dds A Professional Corporation 828 S Fairmont Ave Lodi CA 95240-5117 Ph: (209) 369-8218 |
| NPI Number | 1700179066 |
|---|---|
| Provider Enumeration Date | 05/19/2011 |
| Last Update Date | 06/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700179066 | NPI | - | NPPES |
| B4058702 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 40587 (California) | Primary |
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