Healthcare Provider Details

I. General information

NPI: 1093822512
Provider Name (Legal Business Name): JEFFREY LYNN FLOWER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3032 E HEBRON PKWY STE 100
CARROLLTON TX
75010-4465
US

IV. Provider business mailing address

3032 E HEBRON PKWY STE 100
CARROLLTON TX
75010-4465
US

V. Phone/Fax

Practice location:
  • Phone: 972-306-2273
  • Fax: 972-306-2022
Mailing address:
  • Phone: 972-306-2273
  • Fax: 972-306-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: