Provider Demographics
NPI:1093724205
Name:FLATLEY, JAMES P (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:FLATLEY
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 1:1656 EAGLE NEST CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708
Mailing Address - Country:US
Mailing Address - Phone:407-977-5517
Mailing Address - Fax:
Practice Address - Street 1:4267 W LAKE MARY BLVD
Practice Address - Street 2:CLASSIC DENTAL
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746
Practice Address - Country:US
Practice Address - Phone:407-302-7774
Practice Address - Fax:407-302-5651
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist