Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0401006761 | VA |
NPI | 1740301662 |
---|---|
Provider Name | Dr. William C. Fleenor |
First Address | Madison Heights, VA 24572-2536 |
Second Address | Madison Heights, VA 24572-5346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 09/01/2014 |