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General NPI Number Information
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NPI Number | 1346422557
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Entity Type | Organization
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Legal Business Name | CONWAY ORCHID LLC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 9301 HIGHWAY A1A SUITE 101
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City | VERO BEACH
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State | FL
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Zip | 32963-4500
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Country | US
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Telephone | 772-581-9597
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Fax | 772-581-3664
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Provider Business Mailing Address
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Address Line | 9301 HIGHWAY A1A SUITE 101
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City | VERO BEACH
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State | FL
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Zip | 32963-4500
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Country | US
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Telephone | 772-581-9597
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Fax | 772-581-3664
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Authorized Official
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Title or Position | PARTNER
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Name | DR. EDWARD M CONWAY JR.
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Credential | DDS
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Telephone | 772-581-9597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8492
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License Number State | FL
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