Provider Demographics
NPI:1154563294
Name:TOMLINSON, J. FLINT (DMD)
Entity type:Individual
Prefix:DR
First Name:J.
Middle Name:FLINT
Last Name:TOMLINSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 W 200 N
Mailing Address - Street 2:#62-16
Mailing Address - City:ROOSEVELT
Mailing Address - State:UT
Mailing Address - Zip Code:84066-2743
Mailing Address - Country:US
Mailing Address - Phone:435-722-0202
Mailing Address - Fax:435-722-0238
Practice Address - Street 1:481 W 200 N
Practice Address - Street 2:#62-16
Practice Address - City:ROOSEVELT
Practice Address - State:UT
Practice Address - Zip Code:84066-2743
Practice Address - Country:US
Practice Address - Phone:435-722-0202
Practice Address - Fax:435-722-0238
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6629053-99221223G0001X
UT6629053-89031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice