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NPI Code Detail

MEDICARE: CANDACE OCONNOR DDS

MEDICARE:   CANDACE  OCONNOR  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
11223G0001XGeneral Practice DentistryMT2173MT

General Provider Information

NPI Number : 1477744399
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE OCONNOR DDS
Provider Business Mailing Address
First Line : 1547 S HIGGINS AVE
Second Line : SUITE A
City : MISSOULA
State : MT
Zip : 59801-4226
Country : US
Telephone Number : 406-549-2778
Fax Number : 406-728-6160
Provider Business Practice Location Address
First Line : 1547 S HIGGINS AVE
Second Line : SUITE A
City : MISSOULA
State : MT
Zip : 59801-4226
Country : US
Telephone Number : 406-549-2778
Fax Number : 406-728-6160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2007
Last Update Date : 08/06/2007

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Directions to “ CANDACE OCONNOR DDS” Practice Location

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