Organization
L. MICHELLE CONNER DDS PA DBA BEACON DENTAL CENTER
Active
Other names
Beacon Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILLIAN MICHELLE CONNER DDS (OWNER)
(704) 527-1228
Entity
Organization
Contact information
Practice address
4805 PARK RD, #223, CHARLOTTE, NC 28209-3803
(704) 527-1228
Mailing address
4805 PARK RD, #223, CHARLOTTE, NC 28209-3803
(704) 527-1228
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6133
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89902A2
—
NC
Enumeration date
07/13/2010
Last updated
07/13/2010
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