Provider Demographics
NPI:1316931009
Name:FLANAGIN, MARLIN L (DDS)
Entity type:Individual
Prefix:DR
First Name:MARLIN
Middle Name:L
Last Name:FLANAGIN
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 1:1200 C OF E DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2578
Mailing Address - Country:US
Mailing Address - Phone:620-343-3171
Mailing Address - Fax:620-342-6277
Practice Address - Street 1:1200 C OF E DR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2578
Practice Address - Country:US
Practice Address - Phone:620-343-3171
Practice Address - Fax:620-342-6277
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS65241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice