Provider Demographics
NPI:1659729382
Name:JON T FLINT, DMD, PLLC
Entity Type:Organization
Organization Name:JON T FLINT, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:T
Authorized Official - Last Name:FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-482-8553
Mailing Address - Street 1:3512 HIGHWAY 39 N
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-1305
Mailing Address - Country:US
Mailing Address - Phone:601-482-8553
Mailing Address - Fax:601-482-8563
Practice Address - Street 1:3512 HIGHWAY 39 N
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-1305
Practice Address - Country:US
Practice Address - Phone:601-482-8553
Practice Address - Fax:601-482-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS3635-12OtherDENTIST