Provider Demographics
NPI:1699228122
Name:FLANDERS, DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FLANDERS
Suffix:
Gender:M
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:US DENTAL ACTIVITY BAVARIA
Mailing Address - Street 2:GEBAUDE 316 ROSE BARRACKS,SUEDLAGER
Mailing Address - City:VILECK
Mailing Address - State:GERMANY
Mailing Address - Zip Code:92249
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US DENTAL ACTIVITY BAVARIA
Practice Address - Street 2:GEBAUDE 316 ROSE BARRACKS,SUEDLAGER
Practice Address - City:VILECK
Practice Address - State:GERMANY
Practice Address - Zip Code:92249
Practice Address - Country:DE
Practice Address - Phone:314-590-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist