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General NPI Number Information
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NPI Number | 1073668786
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Entity Type | Individual
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Provider Name | KATHLEEN ANN CONDERATO DDS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 7700 W ARROWHEAD TOWNE CTR
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City | GLENDALE
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State | AZ
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Zip | 85308-8616
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Country | US
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Telephone | 623-937-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 30840 N 42ND PL
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City | CAVE CREEK
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State | AZ
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Zip | 85331-5893
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Country | US
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Telephone | 419-564-5368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008598
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License Number State | AZ
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