MEDICARE: DR. GEORGE D. CONARD JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2640	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000762872	OTHER	WV	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225058886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE D. CONARD JR. D.D.S.

Provider Business Mailing Address
First Line	:	1562 E PEA RIDGE RD.
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25705-7685
Country	:	US
Telephone Number	:	304-736-4794
Fax Number	:	304-736-1135

Provider Business Practice Location Address
First Line	:	1562 E PEA RIDGE RD.
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25705-7685
Country	:	US
Telephone Number	:	304-736-4794
Fax Number	:	304-736-1135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/19/2024

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Directions to “ DR. GEORGE D. CONARD JR. D.D.S.” Practice Location

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