# PAUL W CONRAD DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720148653
- **Authorized official:** WENDY JAYNE MUELLER (FRONT OFFICE MANAGER)
- **Authorized official phone:** (703) 670-4838

## Contact information

- **Practice address:** 16150 COUNTRY CLUB DRIVE, DUMFRIES, VA 22025
- **Practice address phone:** (703) 670-4838
- **Practice address fax:** (703) 670-7876
- **Mailing address:** 16150 COUNTRY CLUB DRIVE, DUMFRIES, VA 22025
- **Mailing address phone:** (703) 670-4838
- **Mailing address fax:** (703) 670-7876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 06/17/2008