Provider Demographics
NPI:1053698985
Name:DR NICK I FLEURY DMD PLLC
Entity type:Organization
Organization Name:DR NICK I FLEURY DMD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:I
Authorized Official - Last Name:FLEURY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-515-4060
Mailing Address - Street 1:178 DANIEL WEBSTER HWY
Mailing Address - Street 2:
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-5664
Mailing Address - Country:US
Mailing Address - Phone:603-515-4060
Mailing Address - Fax:
Practice Address - Street 1:173 NH ROUTE 104 STE A
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-5732
Practice Address - Country:US
Practice Address - Phone:603-515-4060
Practice Address - Fax:603-782-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33041223G0001X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty