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General NPI Number Information
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NPI Number | 1447737911
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Entity Type | Individual
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Provider Name | MATTHEW B CONLEY DMD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 55 BELMONT ST
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City | LABELLE
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State | FL
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Zip | 33935-4789
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Country | US
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Telephone | 863-675-0019
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 953
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City | LABELLE
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State | FL
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Zip | 33975-0953
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Country | US
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Telephone | 863-517-1272
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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 | 23701
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License Number State | FL
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