Provider Demographics
NPI:1134208507
Name:FLANARY, CAROLYN MCKENZIE (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:MCKENZIE
Last Name:FLANARY
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 1:16789 SAN PEDRO AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2349
Mailing Address - Country:US
Mailing Address - Phone:210-494-7660
Mailing Address - Fax:210-496-3606
Practice Address - Street 1:16789 SAN PEDRO AVENUE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2349
Practice Address - Country:US
Practice Address - Phone:210-494-7660
Practice Address - Fax:210-496-3606
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics