Healthcare Provider Details

I. General information

NPI: 1538137716
Provider Name (Legal Business Name): THOMAS DEAN FLANDERS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 PHOEBE LN
DELHI NY
13753-3468
US

IV. Provider business mailing address

225 PHOEBE LN
DELHI NY
13753-3468
US

V. Phone/Fax

Practice location:
  • Phone: 607-746-3555
  • Fax: 607-746-7795
Mailing address:
  • Phone: 607-746-3555
  • Fax: 607-746-7795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number34629
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: