Provider Demographics
NPI:1033370853
Name:WEBB, ELIZABETH FLANAGAN (DDS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FLANAGAN
Last Name:WEBB
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5470 HIXSON PIKE STE A
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-3299
Mailing Address - Country:US
Mailing Address - Phone:423-842-0165
Mailing Address - Fax:423-842-7614
Practice Address - Street 1:5470 HIXSON PIKE STE A
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-3299
Practice Address - Country:US
Practice Address - Phone:423-842-0165
Practice Address - Fax:423-842-7614
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN91121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1527928Medicaid