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General NPI Number Information
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NPI Number | 1669602116
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Entity Type | Individual
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Provider Name | JONATHAN DAVID CONOVER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 8464 WINTON RD
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City | CINCINNATI
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State | OH
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Zip | 45231-4938
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Country | US
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Telephone | 513-931-7542
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Fax |
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Provider Business Mailing Address
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Address Line | 8005 PLAINFIELD RD STE 31
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City | CINCINNATI
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State | OH
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Zip | 45236-2500
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Country | US
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Telephone | 513-791-8937
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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 | 30-023009
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License Number State | OH
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