Provider Demographics
NPI:1710006457
Name:FLOOD, JUSTIN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:C
Last Name:FLOOD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 SKIPPACK PIKE
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:SKIPPACK
Mailing Address - State:PA
Mailing Address - Zip Code:19474-1143
Mailing Address - Country:US
Mailing Address - Phone:610-584-6700
Mailing Address - Fax:610-854-8955
Practice Address - Street 1:3900 SKIPPACK PIKE
Practice Address - Street 2:SUITE C-1
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474-1143
Practice Address - Country:US
Practice Address - Phone:610-584-6700
Practice Address - Fax:610-584-8955
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031294L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice