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General NPI Number Information
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NPI Number | 1740720671
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Entity Type | Individual
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Provider Name | CONNER JAMES SHERWOOD DDS
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Gender | Male
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Dates
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Enumeration Date | 02/25/2017
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 3159 BEAUMONT CENTRE CIRCLE STE 375
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City | LEXINGTON
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State | KY
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Zip | 40513-1001
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Country | US
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Telephone | 859-278-9376
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Fax | 859-276-0260
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Provider Business Mailing Address
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Address Line | 206 SUNSET DR
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City | GREENSBORO
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State | NC
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Zip | 27408-6538
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Country | US
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Telephone | 336-337-9433
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 10896
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 10896
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License Number State | KY
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