Healthcare Provider Details

I. General information

NPI: 1356535629
Provider Name (Legal Business Name): JOHN J FLOWERS JR DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 W MAIN ST STE 201
DOTHAN AL
36301-1250
US

IV. Provider business mailing address

2431 W MAIN ST STE 201
DOTHAN AL
36301-1250
US

V. Phone/Fax

Practice location:
  • Phone: 334-793-9635
  • Fax: 334-793-0501
Mailing address:
  • Phone: 334-793-9635
  • Fax: 334-793-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number5232
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number3098
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JOHN J FLOWERS
Title or Position: PRESIDENT
Credential: DMD
Phone: 334-793-9635