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General NPI Number Information
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NPI Number | 1780299891
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Entity Type | Organization
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Legal Business Name | CRAIG W. CONROW DDS MS INC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 73993 HIGHWAY 111 STE 200
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City | PALM DESERT
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State | CA
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Zip | 92260-4034
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Country | US
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Telephone | 760-775-4688
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Fax |
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Provider Business Mailing Address
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Address Line | 73993 HIGHWAY 111 STE 200
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City | PALM DESERT
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State | CA
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Zip | 92260-4034
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Country | US
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Telephone | 760-775-4688
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING LEAD
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Name | JENNY GARCIA-ROCHA
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Credential |
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Telephone | 972-869-3789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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