Provider Demographics
NPI:1265844310
Name:FLAVELL, AINSLEE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:AINSLEE
Middle Name:MARIE
Last Name:FLAVELL
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 1:2 WELLSPRING RD
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9401
Mailing Address - Country:US
Mailing Address - Phone:207-284-5957
Mailing Address - Fax:207-283-1140
Practice Address - Street 1:35939 MORAVIAN DR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-2139
Practice Address - Country:US
Practice Address - Phone:586-665-0137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME43881223G0001X
MI2901022301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice