Provider Demographics
NPI:1841483500
Name:FLYNN, DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:FLYNN
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 1:460 S 400 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4975
Mailing Address - Country:US
Mailing Address - Phone:385-489-0777
Mailing Address - Fax:
Practice Address - Street 1:460 S 400 E
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4975
Practice Address - Country:US
Practice Address - Phone:801-292-1304
Practice Address - Fax:801-294-2985
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2019-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT48200809922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist