MEDICARE: DR. DAVID THOMAS FLANAGAN 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	LA3400	LA

General Provider Information

NPI Number	:	1235352097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID THOMAS FLANAGAN DDS

Provider Business Mailing Address
First Line	:	3128 SAINT ANDREWS DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5939
Country	:	US
Telephone Number	:	337-478-9688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 2ND AVE
Second Line	:	SUITE B
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8902
Country	:	US
Telephone Number	:	337-478-1404
Fax Number	:

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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