Organization
DAVID J.CONNER D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J CONNER D.D.S. (OWNER/PRESIDENT)
(601) 947-4828
Entity
Organization
Contact information
Practice address
17215 HWY 26, LUCEDALE, MS 39452
(601) 947-4828
(601) 947-4829
Mailing address
PO BOX 707, LUCEDALE, MS 39452-0707
(601) 947-4828
(601) 947-4829
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1664-75
MS
122300000X
Dentist
3392-06
MS
122300000X
Dentist
5712
LA
122300000X
Dentist
D2697
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03306702
—
MS
05
—
07288757
—
MS
Enumeration date
04/09/2009
Last updated
04/09/2009
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