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NPI Code Detail

MEDICARE: DR. HARRY S CONN DDS

MEDICARE: DR. HARRY S CONN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist3592VA

General Provider Information

NPI Number : 1427143726
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HARRY S CONN DDS
Provider Business Mailing Address
First Line : 5309 DISCOVERY PARK BLVD
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-2789
Country : US
Telephone Number : 757-564-0900
Fax Number : 757-564-0034
Provider Business Practice Location Address
First Line : 5309 DISCOVERY PARK BLVD
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-2789
Country : US
Telephone Number : 757-564-0900
Fax Number : 757-564-0034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 01/03/2008

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