Provider Demographics
NPI:1063675924
Name:FLANNAGAN, JOHN ANDREWS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREWS
Last Name:FLANNAGAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 CHRISTINE AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4657
Mailing Address - Country:US
Mailing Address - Phone:256-238-8881
Mailing Address - Fax:256-238-8803
Practice Address - Street 1:1115 CHRISTINE AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4657
Practice Address - Country:US
Practice Address - Phone:256-238-8881
Practice Address - Fax:256-238-8803
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL56191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice