Individual
ANTON CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1113 PROGRESS DR, MEDFORD, OR 97504-5201
(541) 512-3900
(541) 512-1026
Mailing address
5201 WALZEM RD, WINDCREST, TX 78218-2122
(210) 503-0000
(281) 533-6130
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D9787
OR
1223G0001X
General Practice Dentistry
Primary
31423
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/09/2012
Last updated
05/11/2017
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