Healthcare Provider Details
I. General information
NPI: 1679762777
Provider Name (Legal Business Name): JAMES M. FLYNN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/15/2007
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1640 E RIVER RD STE 12
TUCSON AZ
85718-7644
US
IV. Provider business mailing address
12337 N CLOUD RIDGE DR
ORO VALLEY AZ
85755-6563
US
V. Phone/Fax
- Phone: 520-299-4470
- Fax:
- Phone: 520-575-9449
- Fax: 520-469-9922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 5690 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: