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General NPI Number Information
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NPI Number | 1134786486
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Entity Type | Individual
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Provider Name | KAYLAN ROSE FLANIGAN DMD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 172 E MERRITT ST
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City | PRESCOTT
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State | AZ
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Zip | 86301-2026
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Country | US
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Telephone | 928-443-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 N RACE TRACK RD
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City | PRESCOTT
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State | AZ
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Zip | 86305-8969
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Country | US
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Telephone | 218-298-1992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D010333
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License Number State | AZ
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