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General NPI Number Information
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NPI Number | 1568569416
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Entity Type | Organization
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Legal Business Name | KATHERINE V. CONWAY D.D.S. P. A
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 955 HIGHWAY 55 SUITE 6
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City | HASTINGS
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State | MN
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Zip | 55033-2365
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Country | US
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Telephone | 651-437-9764
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Fax | 651-438-3138
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Provider Business Mailing Address
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Address Line | 955 HIGHWAY 55 SUITE 6
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City | HASTINGS
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State | MN
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Zip | 55033-2365
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Country | US
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Telephone | 651-437-9764
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Fax | 651-438-3138
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. KATHERINE VERONICA CONWAY
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Credential | DDS
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Telephone | 651-437-9764
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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 | 10148
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License Number State | MN
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