Individual
DR. TIMOTHY J FLANIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
(920) 431-1715
Mailing address
3417 BLACKBERRY LN, GREEN BAY, WI 54313-8780
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3198
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33733200
—
WI
Enumeration date
08/10/2006
Last updated
07/08/2007
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