MEDICARE: DR. STEPHEN FLANDERS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18468	CA

General Provider Information

NPI Number	:	1154304202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN FLANDERS DDS

Provider Business Mailing Address
First Line	:	6542 BRIGHT AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4503
Country	:	US
Telephone Number	:	562-693-9263
Fax Number	:	562-693-8135

Provider Business Practice Location Address
First Line	:	6542 BRIGHT AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4503
Country	:	US
Telephone Number	:	562-693-9263
Fax Number	:	562-693-8135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/08/2007

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