Provider Demographics
NPI:1093921777
Name:FLYNN, MONICA ALANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:ALANA
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3701
Mailing Address - Country:US
Mailing Address - Phone:210-822-7002
Mailing Address - Fax:210-824-1433
Practice Address - Street 1:7231 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3701
Practice Address - Country:US
Practice Address - Phone:210-822-7002
Practice Address - Fax:210-824-1433
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206831223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1360869OtherUNITED CONCORDIA ID