Provider Demographics
NPI:1740542349
Name:FLAIZ, REBECCA RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RENEE
Last Name:FLAIZ
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 1:3623 LOIS DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-8755
Mailing Address - Country:US
Mailing Address - Phone:541-386-3818
Mailing Address - Fax:
Practice Address - Street 1:3623 LOIS DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-8755
Practice Address - Country:US
Practice Address - Phone:541-386-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist