Provider Demographics
NPI:1669696985
Name:FLYNN, TRICIA M (DDS)
Entity type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:M
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 N MCDONALD RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-924-2866
Mailing Address - Fax:509-924-8311
Practice Address - Street 1:1215 N MCDONALD RD
Practice Address - Street 2:SUITE 203
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1048
Practice Address - Country:US
Practice Address - Phone:509-924-2866
Practice Address - Fax:509-924-8311
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE77421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice