Provider Demographics
NPI:1154400463
Name:FLEISCHMAN, TODD ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALAN
Last Name:FLEISCHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 CHRISTIAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2647
Mailing Address - Country:US
Mailing Address - Phone:215-370-0329
Mailing Address - Fax:
Practice Address - Street 1:1608 WALNUT ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5457
Practice Address - Country:US
Practice Address - Phone:215-545-0400
Practice Address - Fax:215-545-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022945001223G0001X
PADS0360871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice