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General NPI Number Information
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NPI Number | 1427083781
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Entity Type | Individual
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Provider Name | MICHAEL HOWARD CONLEY DDS
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 12/21/2018
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Provider Practice Location Address
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Address Line | 2413 GRANT AVE
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City | ST ALBANS
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State | WV
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Zip | 25177
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Country | US
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Telephone | 304-722-2211
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Fax | 304-722-5464
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Provider Business Mailing Address
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Address Line | 1306 W. CORBETT AVE.
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City | SWANSBORO
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State | NC
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Zip | 28584
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Country | US
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Telephone | 910-326-2030
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Fax | 910-326-3192
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9348
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License Number State | NC
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