# L. MICHELLE CONNER DDS PA DBA BEACON DENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beacon Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932411311
- **Authorized official:** DR. LILLIAN MICHELLE CONNER DDS (OWNER)
- **Authorized official phone:** (704) 527-1228

## Contact information

- **Practice address:** 4805 PARK RD, \#223, CHARLOTTE, NC 28209-3803
- **Practice address phone:** (704) 527-1228
- **Mailing address:** 4805 PARK RD, \#223, CHARLOTTE, NC 28209-3803
- **Mailing address phone:** (704) 527-1228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 6133 | ND | Yes |

## Other

- **Enumeration date:** 07/13/2010
- **Last updated:** 07/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 89902A2 | — | NC |