Provider Demographics
NPI:1437152386
Name:FLYNN, JON C (DMD, MDS)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:C
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DMD, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 NOAH REID RD
Mailing Address - Street 2:STE 107
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7223
Mailing Address - Country:US
Mailing Address - Phone:423-893-0557
Mailing Address - Fax:423-893-0765
Practice Address - Street 1:7213 NOAH REID RD
Practice Address - Street 2:STE 107
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7223
Practice Address - Country:US
Practice Address - Phone:423-893-0557
Practice Address - Fax:423-893-0765
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78511223P0300X
GA119181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics