=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548487465
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCIS B FLANAGIN DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2007
-----------------------------------------------------
Last Update Date | 09/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2425 PRINCE ST STE 5
-----------------------------------------------------
City | CONWAY
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72034-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-329-2000
-----------------------------------------------------
Fax | 501-329-2046
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3640 ARLINGTON DRIVE
-----------------------------------------------------
City | CONWAY
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-327-5099
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 3263
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------