Flanigan, Timothy J

Flanigan, Timothy J is an individual health care provider with primary practice located at 430 Main St , Green Bay WI 54301-5115. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Flanigan, Timothy J can be contacted via phone (920) 431-0345.

Contact Information

Primary practice address
430 Main St Green Bay WI 54301-5115
Fax: (920) 431-1715
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3198 Wisconsin

Profile Details

NPI number 1922019405
LBN Legal business name Flanigan, Timothy J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922019405 NPPES
Wisconsin MEDICAID 33733200

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