Provider Demographics
NPI:1083747737
Name:FLOWER, NICOLE PAXSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:PAXSON
Last Name:FLOWER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3672
Mailing Address - Country:US
Mailing Address - Phone:989-793-8650
Mailing Address - Fax:989-793-2400
Practice Address - Street 1:2919 COURT ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3672
Practice Address - Country:US
Practice Address - Phone:989-793-8650
Practice Address - Fax:989-793-2400
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016819122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383546105OtherTAX IDENTIFICATION NUMBER