Healthcare Provider Details

I. General information

NPI: 1376460113
Provider Name (Legal Business Name): TORIE MCCONNELL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 5TH AVE
DECORAH IA
52101-1319
US

IV. Provider business mailing address

3221 COUNTY ROAD W14
CRESCO IA
52136-9358
US

V. Phone/Fax

Practice location:
  • Phone: 563-382-2657
  • Fax:
Mailing address:
  • Phone: 563-379-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS-10505
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: