Provider Demographics
NPI:1336990712
Name:FLAUGHER, REBECCA (DMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FLAUGHER
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 1:79 WHITE OAK BLF
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-8109
Mailing Address - Country:US
Mailing Address - Phone:304-206-6545
Mailing Address - Fax:
Practice Address - Street 1:6200 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53213-4145
Practice Address - Country:US
Practice Address - Phone:414-771-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001201122300000X
GADN122936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist