Provider Demographics
NPI:1033518527
Name:FLYNN ORTHODONTICS
Entity type:Organization
Organization Name:FLYNN ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-586-9939
Mailing Address - Street 1:1353 RD.19 PMB 433
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-0096
Mailing Address - Country:US
Mailing Address - Phone:787-200-4902
Mailing Address - Fax:787-200-4902
Practice Address - Street 1:D17 CALLE BUEN SAMARITANO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2025
Practice Address - Country:US
Practice Address - Phone:787-200-4902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty